Abstract
BackgroundMcKittrick–Wheelock syndrome (MKWS) is caused by a villous tumor of the rectosigmoid colon with hypersecretion of mucus containing electrolytes. Complete resection of the tumor is needed to cure this disease. Transanal total mesorectal excision (TaTME) is currently a promising treatment for lower rectal tumor because of the reliability of its resection margin especially in bulky tumor. We present this first case report of a TaTME for MKWS with a lower rectal tumor.Case presentationAn 81-year-old woman was admitted to our hospital with diarrhea and acute renal failure. Computed tomography and magnetic resonance imaging examinations revealed an 80-mm-sized enhanced tumor located in her lower rectum without lymph node swelling and distant metastasis. A giant villous tumor secreting mucus was seen in the lower rectum to the anal canal during colonoscopy. The result of tumor biopsy was adenocarcinoma. To preserve the anal function and ensure distal margin, we chose TaTME for curative resection. After improving the electrolyte imbalance, TaTME was performed successfully and R0 resection was achieved. There was no sign of recurrence or electrolyte depletion for 1 year after the surgery.ConclusionTaTME could be a promising surgical approach for giant villous tumor with MKWS in the lower rectum.
Highlights
McKittrick–Wheelock syndrome (MKWS) was first reported as a rare syndrome characterized by dehydration, electrolyte depletion, and renal failure due to secretory diarrhea from villous tumor of the rectosigmoid colon [1]
Transanal total mesorectal excision (TaTME) has the advantage of obtaining TME and quality of life through visualization of the distal part of the surgical plane especially in case of bulky tumor [5, 6]
Case presentation An 81-year-old woman was admitted to our hospital suffering from general fatigue and severe diarrhea, which contained a lot of mucus
Summary
McKittrick–Wheelock syndrome (MKWS) was first reported as a rare syndrome characterized by dehydration, electrolyte depletion, and renal failure due to secretory diarrhea from villous tumor of the rectosigmoid colon [1]. This tumor causes systemic disease, and has a risk of malignancy due to its size. Case presentation An 81-year-old woman was admitted to our hospital suffering from general fatigue and severe diarrhea, which contained a lot of mucus On physical examination, she did not have abdominal pain with normal vital sign. The CT colonography showed that the tumor was located in the lower rectum with extending into the anal canal (Fig. 2b). The distal margin was more than 5 mm a b c d
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
