Giant tubulovillous adenoma mimicking rectal adenocarcinoma: a diagnostic and therapeutic challenge

Authors

  • Ahmed Jawad Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
  • Hussain Adnan Abdulla Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
  • Asma Alqaseer Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
  • Mohamed Ayed Abushwemeh Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain
  • Basel Alaradi Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain

DOI:

https://doi.org/10.18203/2349-2902.isj20205903

Keywords:

Adenoma, Tubulovillous, Adenocarcinoma

Abstract

Tubulovillous adenomas are benign lesions, which are difficult to interpret because of their malignant potential. They have similar clinical, radiological and pathological features to malignant lesions. Usually, they are asymptomatic but may present with symptoms similar to adenocarcinomas. We present an unusual case of giant tubulovillous adenoma mimicking rectal cancer. The patient underwent neoadjuvant chemoradiation with no change in tumor size. He then underwent laparoscopic low anterior resection and final histopathology revealed giant tubulovillous adenoma.

References

Mărginean CO, Mărginean MO, Simu I, Horvath A, Meliţ LE. Giant tubular adenoma with malignancy clinical characteristics in a female teenager: case report and a review of the literature. Medicine. 2016;95(40).

Euscher ED, Niemann TH, Lucas JG, Kurokawa AM, Frankel WL. Large colorectal adenomas: an approach to pathologic evaluation. Am J Clinic Pathol. 2001;116(3):336-40.

Druliner BR, Wang P, Bae T, Baheti S, Slettedahl S, Mahoney D, et al. Molecular characterization of colorectal adenomas with and without malignancy reveals distinguishing genome, transcriptome and methylome alterations. Scientif Rep. 2018;8(1):1-0.

Munding J, Tannapfel A. Epidemiology of colorectal adenomas and histopathological assessment of endoscopic specimens in the colorectum. Viszeralmedizin. 2014;30:10-6.

Bains L, Lal P, Vindal A, Singh M. Giant villous adenoma of rectum-what is the malignant potential and what is the optimal treatment? A case and review of literature. World J Surgic Oncol. 2019;17(1):109.

Das P, Vijay MK, Yadav R, Kumar S, Sharma J, Gupta SD. Giant villous adenoma of rectum mimicking an infiltrating adenocarcinoma. Tropic Gastroenterol. 2015;36(2):137-9.

Gonzalez RS, Cates JM, Washington MK, Beauchamp RD, Coffey RJ, Shi C. Adenoma‐like adenocarcinoma: a subtype of colorectal carcinoma with good prognosis, deceptive appearance on biopsy and frequent KRAS mutation. Histopathology. 2016;68(2):183-90.

Roriz-Silva R, Andrade AA, Ivankovics IG. Giant rectal villous adenoma: surgical approach with rectal eversion and perianal colonanal anastomosis. Int J Surg Case Rep. 2014;5(2):97-9.

Choi WH, Ryuk J, Kim HJ, Park SY, Park JS, Kim JG, et al. A case of giant rectal villous tumor with severe fluid-electrolyte imbalance treated by laparoscopic low anterior resection. J Korean Surg Soc. 2012;82(5):325-9.

Hosn MA, Abdel-Hafiez N, Abdel-Wahab R, Al-Ahmadie A, Antar A, Dbouk H, et al. A giant rectal villous adenoma with a malicious intent. Gastrointest Cancer Res. 2013;6(5-6):144.

Ya MC, Murdur FA, Gürden GU, Haberal N, Moray G, Boyacio S, Lu MH. A giant villous adenoma case mimicking right colon carcinoma. Turk J Gastroenterol. 2004;15(4):270-3.

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Published

2020-12-28

Issue

Section

Case Reports