The Clinical Significance of a Villous Adenoma

Abstract

It is important to define and to understand the meaning of the many and sometimes confusing names applied to benign epithelial neoplasms of the colon and rectum. ‘Adenoma’ is strictly a histopathological diagnosis, and, two distinctive growth patterns, tubular and villous, or an admixture of these two, are now internationally accepted by histopathologists. ‘Villous’ is a descriptive term used both by pathologists and by clinicians. ‘Villous tumours’, about which I propose to speak, do seem to constitute a recognisable clinical entity. An alternative nomenclature is villous papilloma. To the touch (and fortunately the majority are sited in the rectum within reach of the index finger) they feel soft and velvety; by endoscopy the slender branching villi can be seen, often floating in clear mucus, and this is a characteristic appearance, as illustrated in fig. 1.