A CASE OF VILLOUS ADENOMA IN THE RECTUM COEXISTING WITH ADVANCED CANCER

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Only a few cases of villous adenoma in the colon have been reported in Japan. This is a presentation of a case with villous adenoma showing flat protuberance, with proceeded to adenocarcinoma at the central part. The patient was 79-year-old housewife who was admitted to Osaka Medical College with a chief complaint of constipation for about half year. Physical examination revealed no abnormalities except for a palpable mass in the rectum by digital examination. Barium enema showed filling defect which was clearly demarcated by surrounding tissue. Surface of the filling defect was irregular and the pooling of barium was found at the center of the defect. Endoscopically, a protuberant mass with gyrus-like appearance was observed. The center of the mass was depressed, and the surface of this area was irregular and covered with dirty coating. Biopsied specimens taken from the protuberant and depressed areas showed villous adenoma and tubular adenocarcinoma, respectively. The consecutive section of the resected mass showed villous adenoma which proceeded to adenocarcinoma at the center of this mass. Infiltration of the carcinoma cells reached to the muscle layer. In addition to our case, we discussed frequency, age, symptoms, morphology and complications of villous adenoma inthe colon described in the literature.
社団法人日本消化器内視鏡学会の論文