[A Case of a Colorectal Villous Tumor with Electrolyte Depletion Syndrome Treated with Robot-Assisted Surgery].

Q4 Medicine Japanese Journal of Cancer and Chemotherapy Pub Date : 2024-09-01
Shuhei Narita, Tsuyoshi Ohtani, Yuko Takehara, Tetsuya Katayama, Kaori Nitta, Eiki Miyake, Tomokazu Fuji, Masanobu Maruyama, Yoshihiro Akazai, Soichiro Nose
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Abstract

Colorectal villous tumors secrete large amounts of mucus that can cause electrolyte abnormalities and dehydration, a condition known as electrolyte depletion syndrome. A woman in her 70s, who had been underweight for 10 years with a body mass index(BMI)of 16, was admitted to our hospital with electrolyte abnormalities, renal disorders, and rectal tumors. The electrolyte abnormalities and renal disorders were corrected relatively quickly with supplemental fluid therapy. Notably, 1,000 g of mucus stool per day was observed; subsequently, a lower gastrointestinal endoscopy revealed a circumferential villous tumor in the Rb of the rectum, which was biopsied and diagnosed as rectal cancer and electrolyte depletion syndrome. The patient was temporarily discharged from the hospital; however, several days later, the electrolyte abnormalities and renal disorders recurred. The patient was readmitted to the hospital and underwent robot-assisted Hartmann's surgery after improvement of the general condition of the patient. Postoperative pathology revealed papillary adenocarcinoma with SM depth, and the patient progressed without recurrence or relapse of electrolyte depletion syndrome.

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[机器人辅助手术治疗伴有电解质耗竭综合征的结直肠绒毛膜肿瘤病例]。
大肠绒毛肿瘤会分泌大量粘液,导致电解质异常和脱水,这种情况被称为电解质消耗综合征。一位 70 多岁的妇女因电解质异常、肾功能紊乱和直肠肿瘤入院,她体重过轻已有 10 年,体重指数(BMI)为 16。通过补充液体治疗,电解质异常和肾功能紊乱很快得到了纠正。值得注意的是,患者每天排出 1 000 克粘液便;随后,下消化道内镜检查发现直肠 Rb 部有一环状绒毛状肿瘤,经活检后诊断为直肠癌和电解质消耗综合征。患者暂时出院,但几天后,电解质异常和肾功能紊乱再次出现。患者再次入院,在全身情况好转后接受了机器人辅助的哈特曼手术。术后病理结果显示乳头状腺癌,深度为 SM,患者病情无复发或电解质缺失综合征复发。
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