Giant Villous Tumor with Electrolyte Depletion Syndrome Treated with Laparoscopic Abdominoperineal Resection—A Case Report—

Abstract

A 72-year-old man visited our hospital with anorexia and chronic diarrhea. Laboratory evaluation showed severe dehydration with renal dysfunction and electrolyte imbalance. Abdominal computed tomography revealed a giant wrinkled tumor in the pelvic cavity. Colonoscopy revealed a mucus-secreting giant villous tumor, and histopathological evaluation showed a moderately differentiated tubular adenocarcinoma. Laparoscopic abdominoperineal resection was performed for the villous tumor that was accompanied by electrolyte depletion syndrome. We manually applied pressure over the lower abdomen at the commencement of surgery to enable inversion of the tumor out of the anus, which ensured better visualization of the surgical field for safe rectal resection. The tumor measured 21 × 25 cm in size, and histopathological evaluation of the resected specimen confirmed diagnosis of adenocarcinoma with villous tubular adenoma (pT1a, pN0, cM0, Stage I). The patient was discharged 14 days postoperatively without electrolyte imbalance, and no recurrence has been observed. Endoscopic or surgical resection is feasible for treatment of villous tumors associated with electrolyte depletion syndrome.