Villous Adenomas of the Colon, Benign or Malignant?

"When a thing ceases to be a subject of controversy, it ceases to be a subject of interest." William Hazlitt, 1830 Controversy exists over the definition, nature, diagnosis, and treatment of villous adenomas of the colon. We have analyzed our experience and reviewed the reports of others hoping to answer some of these questions. Our study included 97 patients from the University of Nebraska Hospitals and 1,330 patients reported in the English language. As a result, we accept some old ideas, question others, and introduce a new concept of treatment. Method and Material It was our purpose to review our experience with clinically benign villous adenomas. We considered clinically benign those villous adenomas of the colon showing no evidence of induration, ulceration, or metastases by history and physical examination, sigmoidoscopy, barium enema, and x-ray film studies of the chest. In order to find the patients with villous adenomas, we had