Presentation
While most of the right colonic lesions present with features of anaemia, the left colonic lesions show altered bowel habit, blood in stool and intestinal obstruction. [tropicalgastro.com]
Synchronous neoplasms are uncommon and present unique considerations for treatment and prognosis. [mdmag.com]
If patients do present with symptoms, commonly they will endorse a history of blood per rectum. [ncbi.nlm.nih.gov]
Case presentation: In this case we describe a female patient suffering from 6 months of secretory diarrhea, presented to our emergency department with severe dehydration, acute renal failure, hyponatremia and hypokalemia After re hydration and electrolyte [oatext.com]
Case Presentation A 64-year-old female presented to the outpatient clinic with a four-month history of painless progressive jaundice of skin and eyes along with loss of appetite and weight loss. [cureus.com]
Entire Body System
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Physician
Although physicians debate this, and the evidence does not completely confirm, thus far, if villous features indicate an increased risk of developing colorectal cancer, multiple studies demonstrate that histologic villous features of adenomas may be associated [ncbi.nlm.nih.gov]
Research and Development, The University of Texas MD Anderson Cancer Center Manoop S Bhutani, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Gastroenterology, American College of Physicians [emedicine.medscape.com]
Liver, Gall & Pancreas
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Jaundice
Though they are mostly asymptomatic, sometimes they may present with the signs and symptoms of jaundice (obstructive jaundice), abdominal pain, melena, hematochezia, fever, malaise or weight loss. [cureus.com]
Jaundice may be present with villous adenoma of the ampulla. Causes Genetic factors: From the NPS data, relatives of patients with polyps have an increased risk of carcinoma. [odlarmed.com]
He also reported experiencing no nausea, vomiting, jaundice, shortness of breath, dark urine, fevers, chills, or sweats. Routine laboratory evaluations revealed microcytic anemia and a hemoglobin level of 4.2 g/dL. [mdmag.com]
Jaundice may be present with villous adenoma of the ampulla. Causes: Genetic factors: From the NPS data, relatives of patients with polyps have an increased risk of carcinoma. [nulytely.com]
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Hepatomegaly
CT Abdomen and Pelvis: Hepatomegaly 17cm (Homogenous CT density, no HFLs), Single GB stone (2cm, normal GB wall thickness) and Multiple uterine fibroids Colonoscopy was done and revealed 3 sessile colonic polyps (2 at distal end of Transverse colon, largest [oatext.com]
Musculoskeletal
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Myalgia
The patient reported 72 hours of lethargy, myalgia, generalised weakness and cramps, following 3 weeks of watery diarrhoea, with pink-stained mucous discharge. He reported 10 motions per day, and no abdominal pain or vomiting. [mja.com.au]
Workup
The primary care giver and nurse practitioner should refer these patients to a gastroenterologist or general surgeon for further workup and removal of the lesion. [ncbi.nlm.nih.gov]
Index Author Information Introduction Clinical Differentials Workup Treatment Medication Follow-up Miscellaneous Pictures Bibliography Synonyms and related keywords papillary adenoma, malignancy, tubular adenoma, tubulovillous adenoma, tubulo-villous [nulytely.com]
Serum
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Hyponatremia
Dehydration with severe hyponatremia, hypokalemia, metabolic acidosis, acute renal failure and watery diarrhea is typical. Exact diagnosis is difficult require a high level of suspicion and early colonoscopy for visualization and biopsy. [oatext.com]
Fecal mass PATHOLOGY • Malignant potential: Lesions 1 cm (5%), 1-2 cm (10%), 2 cm (53%) CLINICAL ISSUES • Asymptomatic, diarrhea, pain, rectal bleeding, or melena • Lesion closer to rectum: More likely to have diarrhea, electrolyte loss (hypokalemia and hyponatremia [clinicalgate.com]
Precautions Category D in third trimester of pregnancy; may cause fluid retention and peripheral edema; caution in compromised cardiac function, hypertension, conditions predisposing to fluid retention, severe heart failure, and hyponatremia because may [nulytely.com]
Treatment
[…] adults, commonly in rectum or rectosigmoid Less frequent than tubular adenoma ( eMedicine ) May invade directly into colon wall since no stalk is present to serve as buffer zone Higher risk of malignancy than tubular adenoma; 40% risk if sessile and 4 cm Treatment [pathologyoutlines.com]
The broad range of reported recurrence rates for treatment of villous adenoma of the rectum indicates a need for additional data. [jamanetwork.com]
Alternative imaging studies include: CT colonography Video capsule endoscopy Treatment Medical Therapy There is no medical therapy for villous adenoma. Surgical removal of the adenoma is the mainstay of treatment. [wikidoc.org]
This uncommon condition raises prognostic and treatment dilemmas. [mdmag.com]
Aggressive hydro electrolyte rebalancing is often needed, and curative treatment is obtained only with complete removal of the lesion, by endoscopic resection or surgery. [oatext.com]
Prognosis
[15] Prognosis becomes poor with malignant transformation of the lesion. [wikidoc.org]
Synchronous neoplasms are uncommon and present unique considerations for treatment and prognosis. [mdmag.com]
It is a benign tumor with excellent prognosis, but its progression to adenocarcinoma is not established. Here, we report an additional case of villous adenoma of the urinary bladder. [cancerjournal.net]
This would benefit both the patient’s prognosis and quality of life. [bjuinternational.com]
Increased expression of the tumor suppresser gene, TP53, and also of cellular proliferation markers (proliferating cell nuclear antigen and MIB-1) has been detected in the villous adenoma. 7 TREATMENT AND PROGNOSIS Prognosis is excellent for patients [archivesofpathology.org]
Etiology
Furthermore, the etiology of the diarrhea is often difficult to establish by the usual technics. [nejm.org]
Colonoscopy ( confirmatory test ) References: [1] Treatment Treatment depends on the etiology and nature of the polyp or polyps. References: [1] [2] [amboss.com]
Adenomas with villous features may be associated with a slight increase in development of more advanced neoplasia or dysplasia compared to other types of adenomas. [1] [2] [3] Etiology The risk of developing colorectal polyps is related to both environmental [ncbi.nlm.nih.gov]
McKittrick-Wheelock syndrome: a rare etiology of acute renal failure associated to well-differentiated adenocarcinoma (G1) arising within a villous adenoma. Rom J Morphol Embryol. 2011;52(3 Suppl):1153–6. 28. Dagan A, Reissman P. [wjso.biomedcentral.com]
Epidemiology
Villous adenoma Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Xyz from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and [wikidoc.org]
Clinical, autopsical, and epidemiological studies provide evidence of adenoma-to-carcinoma progression. The mean age of adenoma diagnosis is 10 years earlier than with carcinoma, and progression to carcinoma takes a minimum of 4 years. [emedicine.medscape.com]
Epidemiology References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
[…] the adenoma bulk is comparatively predictive as the conventional current model using histology features when using a risk stratification cutoff of 10mm for the adenoma bulk, with high-risk adenoma bulk being greater than or equal to 10 mm. [4] [5] [6] Epidemiology [ncbi.nlm.nih.gov]
Pathophysiology
Villous adenoma Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Xyz from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and [wikidoc.org]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. 6th ed. Philadelphia: WB Saunders; 1997. 467-71. Mandel JS, Bond JH, Church TR, et al. [emedicine.medscape.com]
The presence of colonic pseudo-obstruction added another level of complexity to our case. 12 Given the pathophysiology of hypersecretory villous adenoma and the predisposing factors for pseudo-obstruction, this association is not unexpected. [mja.com.au]
Pathophysiology Adenomas are believed to have an abnormal process of cell proliferation and apoptosis. The proliferative component is not confined to the crypt base and accumulates onto the surface and infolds downward. [odlarmed.com]
Pathophysiology: Adenomas are believed to have an abnormal process of cell proliferation and apoptosis. The proliferative component is not confined to the crypt base and accumulates onto the surface and infolds downward. [nulytely.com]
Prevention
"Aspirin for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: A Decision Analysis for the U.S. Preventive Services Task Force". Ann. Intern. Med. 164 (12): 777–86. doi : 10.7326/M15-2129. PMID 27064573. [wikidoc.org]
Nonsteroidal anti-inflammatory drugs, eicosanoids, and colorectal cancer prevention. Gastroenterol Clin North Am. 1996 Dec. 25(4):773-91. [Medline]. Farnell MB, Sakorafas GH, Sarr MG, et al. [emedicine.medscape.com]
Current screening recommendations for the asymptomatic average-risk population (US Preventive Services Task Force) are as follows: Begin screening at age 50 years. [nulytely.com]
Complications are grave and can be prevented by adequate and prompt rehydration and acid base correction is not immediately performed and patient is stabilized [7,8]. [oatext.com]
Future studies of these associations may provide insight into carcinogenetic pathways and lead to new treatments and preventive stratagems. [mdmag.com]