Description
Iurii Munteanu, Silvia Popescu, Mihaela Munteanu, Daniel Cochior
Giant villous adenomas represent rare benign lesions that are sometimes difficult to assess because of their malignant potential. Preoperative biopsy can be tricky due to the fact that the absence of malignant cells in the examined areas cannot exclude their presence in neighboring areas. Even serial biopsies can miss an area of malignant transformation. Therefore, complete removal is recommended for a thorough examination and also to both reduce the risk of cancer and ensure control of local complications. Many surgical techniques have been proposed, but they are difficult to apply in cases with giant and circumferential rectal lesions. We present the case of a 79 year old patient who has been hospitalized for severe anemia due to a giant rectal villous adenoma. After careful consideration of all factors involved, we preferred a radical procedure, consisting in total removal of the mass, with permanent colostomy. This treatment alternative was considered the best option in terms of the risk/benefit ratio, although it is rarely opted for nowadays, due to the effects on the patient’s quality of life.
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