Villous adenoma in 108 patients

One hundred eight patients with grossly benign villous adenomas of the large bowel are reviewed. Approximately 20 per cent of the clinically benign tumors show malignant characteristics histologically. These lesions occur in elderly people with other concurrent disease. About 16 per cent of the patients have other primary cancerous lesions. Recurrence rate in all patients was 9.3 per cent, whereas the operative mortality was 5.5 per cent. In no instance was a recurrent lesion malignant, when the original lesion was histologically benign. We, therefore, urge a conservative approach in therapy; total local excision of the tumor, followed by histologic examination. If it is malignant, an operation for cancer should be performed. If the lesion is benign, the patient should be periodically re-examined.