A Case of Villous Tumor of the Rectum with Electrolyte Depletion Syndrome

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A 77-year-old woman with a 1-year history of general fatigue and 4-month history of severe diarrhea and melena was admitted to a hospital, complaining of a huge tumor prolapsed through the anus. Laboratory data on admission showed severe hypokalemia and severe anemia. A colonoscopy revealed an encircling huge villous tumor in the rectum. Based on the findings of the magnification imaging using crystal violet staining and narrow-band imaging (NBI), we diagnosed the tumor as a villous adenoma with a component of the intramucosal cancer or submucosal superficial cancer. After the improvement of severe anemia and hypokalemia by drip infusion therapy and blood transfusion, we performed a low anterior resection. The size of the tumor was 90mm×80mm. The microscopic findings showed a well differentiated adenocarcinoma invading the mucosa in the villous adenoma. The postoperative course was uneventful and hypokalemia and anemia improved. Sixteen months after surgery, she had no recurrence. This case was considered to be rectal villous tumor with electrolyte depletion syndrome (EDS).