Presentation
Hematochezia, tenesmus, and constipation.
Patient Data
There is an asymmetric wall thickening involving the left lateral margin of the rectum measuring 1.3 x 2.7 cm x 3.3 cm. This may represent adherent stool however underlying mass is not excluded.
There is an incidental left ovarian cyst.
3.6 cm craniocaudal intraluminal mass located 4.8 cm from the anal verge and extending to the anorectal junction with T2 hyperintensity.
No suspicious lymph nodes or invasion of the mass into adjacent structures.
Incidental 3.8 cm left ovarian cyst.
Case Discussion
Diagnosis of villous adenoma without high-grade dysplasia was confirmed via biopsy.
While commonly asymptomatic, adenomas with villous features carry an increased cancer risk compared to other adenoma types and should be excised when discovered. Villous adenomas occur most frequently in the rectosigmoid area and only account for 5-15% of all adenomas.
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