Acute Renal Failure Due to the Giant Vıllous Adenoma of Colon: McKittrick-Wheelock Syndrome

E. Esen, R. Kerimoğlu
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Abstract

Malignant tumors of the colon usually originate from benign adenomas. Adenomas with large size and villous component have higher malignancy potential than other adenomas. Adenomas are usually asymptomatic, but as their size increase, they may cause symptoms such as bleeding, tenesmus, obstruction, intussusception. Mucous diarrhea can be seen due to secretory adenomas that constitute the subgroup of villous adenomas. Secretory adenomas are usually located in the rectosigmoid region and are larger than 4 cm. McKittrick-Wheelock syndrome is characterized by chronic mucous diarrhea, renal failure and electrolyte imbalance due to rectal secretory villous adenoma. Approximately 100 cases have been reported in the literature. Adenoma causing McKittrick Wheelock syndrome carries a hıgh rısk for the development of ınvasıve cancer due to its bıg sıze and hıstologıc sub-type. This syndrome can be fatal due to the metabolic collapse or possible malignancy however early diagnosis and proper treatment may increase quality of life and serve a significant survival advantage for the patients. The importance of being aware of McKittrick-Wheelock syndrome and the need to include this diagnosis in the work up of patients with secretory diarrhea should be highlighted.In this case report, we aimed to present a patient who was diagnosed with rectal cancer and was diagnosed as one of the largest adenomas causing McKittrick-Wheelock
巨大Vıllous结肠腺瘤所致急性肾衰竭:McKittrick-Wheelock综合征
结肠恶性肿瘤通常起源于良性腺瘤。体积大且含有绒毛成分的腺瘤比其他腺瘤具有更高的恶性潜能。腺瘤通常无症状,但随着体积增大,可引起出血、下坠、梗阻、肠套叠等症状。粘液性腹泻是由绒毛状腺瘤亚群中的分泌性腺瘤引起的。分泌性腺瘤通常位于直肠乙状结肠区,体积大于4cm。McKittrick-Wheelock综合征以直肠分泌性绒毛腺瘤引起的慢性黏液性腹泻、肾功能衰竭和电解质失衡为特征。文献中报道了大约100例。由于其bıg sıze和hıstologıc亚型,导致McKittrick Wheelock综合征的腺瘤具有ınvasıve癌症发展的hıgh rısk。由于代谢衰竭或可能的恶性肿瘤,这种综合征可能是致命的,但早期诊断和适当治疗可以提高患者的生活质量,并为患者提供显著的生存优势。应强调认识到McKittrick-Wheelock综合征的重要性,以及在分泌性腹泻患者的工作中纳入这一诊断的必要性。在这个病例报告中,我们的目的是提出一个被诊断为直肠癌的患者,并被诊断为导致McKittrick-Wheelock的最大腺瘤之一
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