Acta Oncol Tur.. 2019; 52(2): 328-331 | DOI: 10.5505/aot.2019.38991

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

Ebru Esen, Ramazan Saygýn Kerimoðlu
Konya Training and Research Hospital, General Surgery, Konya, Turkey

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 hýgh rýsk for the development of ýnvasýve cancer due to its býg sýze and hýstologýc 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 syndrome.

Keywords: Villous adenoma, Chronic diarrhea, Acute renal failure, Electrolyte imbalance, Rectal cancer

---

Kolonun Dev Villöz Adenomuna Baðlý Akut Böbrek Yetmezliði: McKittrick-Wheelock Sendromu

Ebru Esen, Ramazan Saygýn Kerimoðlu
Konya Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Konya, Türkiye

Kolonun malign tümörleri genellikle benign adenomlardan köken almaktadýrlar. Büyük boyutlu ve villöz komponenti olan adenomlarýn malignleþme potansiyelleri diðer adenomlara göre daha fazladýr. Adenomlar genellikle asemptomatikdirler ancak boyutlarý arttýkça kanama, tenesmus, obstruksiyon, intusepsiyon gibi semptomlara neden olabilirler. Villöz adenomlarýn bir kýsmýný oluþturan sekretuar adenomlara baðlý mukuslu diare görülebilir. Sekretuar adenomlar genellikle rektosigmoid bölgede yerleþir ve 4 cm’den büyüktürler. McKittrick-Wheelock sendromu, rektal sekretuar villöz adenoma baðlý olarak geliþen; kronik mukuslu diare, renal yetmezlik ve elektrolit imbalansý triadý ile karþýmýza çýkmaktadýr. Literatürde yaklaþýk olarak 100 civarýnda vaka bildirilmiþtir. Sendroma sebep olan villöz adenom; büyük boyutu ve histolojik tipi nedeni ile invaziv kanser için yüksek risk taþýmaktadýr. Tedavi edilmediði taktirde metabolik kollaps ve malignite gibi yýkýcý sonuçlarý olan bu sendromun sekretuar diare ayýrýcý tanýlarý arasýnda unutulmamasý gerekmektedir. Erken taný ve uygun tedavi ile hayat kalitesinde artma ve belirgin saðkalým avantajý saðlanabilir. Bu olgu sunumunda McKittrick-Wheelock sendromuna sebep olan en büyük boyutlu adenomlardan birinin tespit edildiði ve rektum kanseri tanýsý alan bir hastanýn bilgilerini sunmayý amaçladýk.

Anahtar Kelimeler: Villöz adenom, Kronik diare, Akut böbrek yetmezliði, Elektrolit imbalansý, Rektal kanser

---