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Colon tumor
Polyps
Villous adenoma of colon
Reviewers: Charanjeet Singh, M.D. (see Reviewers page)
Revised: 23 October 2011, last major update August 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.
Clinical features
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● Older adults, commonly in rectum or rectosigmoid
● Less frequent than tubular adenoma (eMedicine)
● May invade directly into colon wall since no stalk is present to serve as buffer zone
● Higher risk of malignancy than tubular adenoma; 40% risk if sessile and > 4 cm
Case reports
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● Mimicking carcinoma (Turk J Gastroenterol 2004;15:270)
● Associated with fluid and electrolyte imbalances (Ugeskr Laeger 2000;162:4272, Ann Surg 1964;159:604)
● Associated with bowel perforation (Dis Colon Rectum 1997;40:244)
Treatment
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● Local excision if small
● May need larger surgery to completely excise, even if benign
Endoscopy
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Gross description
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● Soft, usually large and sessile with papillary villous projections, large base and no stalk; may encircle the bowel
Gross images
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Villous adenoma

Adenocarcinoma arising in villous adenoma
Micro description
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● Long fronds of papillary / villous projections arising directly from mucosal surface
Micro images
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Various images
Villous adenoma #1, #2
Virtual slides
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End of Colon tumor > Polyps > Villous adenoma
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