title: [A Case of Large Rectal Villous Adenoma Associated with Tenesmus and Body Weight Loss].
abstract: The patient was a 78-year-old man who was hospitalized with a 1-month history of tenesmus and body weight loss. Blood tests revealed a mild increase in tumor markers(CEA 9.7 ng/mL)and an elevation of the inflammatory response. Colonoscopic examination disclosed a full circular lateral spreading tumor(LST)extending from the second Houston valve to the rectosigmoidal region with a more than 10 cm length. Since invasion to the SM layer was suspected, endoscopic resection was judged inapplicable and laparoscopic low anterior resection with D2 lymph node dissection was performed, along with covering ileostomy. The final pathology diagnosis was villous adenoma with carcinoma in adenoma, showing multiple villous structures categorized as high dysplasia. Postoperatively, he was free from tenesmus and his body weight increased. In addition, normalization of the tumor markers occurred.
authors.affiliation: Dept. of Surgery, Kaizuka City Hospital.
authors.forename: Miho
authors.initials: M
authors.lastname: Okano
authors.forename: Masaki
authors.initials: M
authors.lastname: Okuyama
authors.forename: Masaya
authors.initials: M
authors.lastname: Nishino
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hoshino
authors.forename: Junji
authors.initials: J
authors.lastname: Kawada
authors.forename: Yongkook
authors.initials: Y
authors.lastname: Kim
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Tsujinaka
mesh_terms: D018253:Adenoma, Villous / Q000150:complications / Q000601:surgery; D000368:Aged; D003082:Colectomy; D003113:Colonoscopy; D006801:Humans; D008297:Male; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D015431:Weight Loss