A STUDY OF TWENTY CASES OF VILLOUS TUMOR OF THE LARGE INTESTINE

Villous tumor of the colon is rare in Japan compared to that in the USA or Europe, but is an interesting disease in terms of its carcinogenesis and surgical treatment. Twenty legions of villous tumors in the colon treated at our hospital from January 1983 to December 1988 were examined clinically and pathologically. The average age was 61.3 years and the male-to-female ratio was equivalent. The frequent first onset of symptom was anal bleeding. It was most frequently found in the sigmoid colon and rectum. About 55% of the patients were associated with cancer. There was no relationship in the size of tumors between benign adenomas and cancers in adenoma. There was also no relationship in the macroscopical types of tumors between them. Histologically the cancers were more frequently associated with villous adenomas compared with tubulo-villous adenomas. In the treatment, the benign adenomas and cancers invading the muscle layer were polypectomized through endoscopes or with trans anal surgical resections. On the other hand, large benign adenomas and cancers with under the invasion depth of submucosa were treated by radical colectomy with dessection of the regional lymphnodes. In a final analysis, we assume that the cancers from villous tumors of the colon predominantly involve cancers from villous adenomas. Moreover, it is important that the villous tumor of the lower rectum should be resected first of all.