Villous Tumor of the Rectum With Electrolyte Disturbance

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Villous tumor of the rectum with serum electrolyte disturbance in a 77-year-old man was recorded. The patient had suffered from mucous diarrhea since the age of 57. At the time of his admission, loss of serum electrolytes (Na 119.6mEq/l; K 3.4mEq/l; Cl 77mEq/l), azotemia (BUN 118mg/dl; creatinine 7.1mg/dl) and dehydration were noted. These severe conditions were improved with a rather small dosage of fluid and elecrolyte infusion because of his activity for oral intake of food and water. After this preoperative procedure, abdominoperineal amputation of the rectum and regional lymphadenectomy were performed. The villous tumor, 13×12×2cm in size, occupied the lower part of the rectum and consisted of villous adenoma and tubulovillous adenoma as well as well-differentiated adenocarcinoma. The mucous secretion appeared in the area of villous adenoma. The patient had an uneventful clinical course and was relieved. However, he suddenly died 10 months after the operation. The autopsy revealed cortical necrosis of the bilateral kidneys. There was no neoplasm. Loss of serum electrolytes and water in a patient with villous tumor of the colon is called “depletion syndrome”. The mechanism of the occurrence of this syndrome is uncertain as yet, but a vicious cycle may participate in its development.