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Management of Villous Adenomas of the Colon and Rectum

Demetre M. Nicoloff, MD, PhD; Cassius M. Ellis, MD; Edward W. Humphrey, MD, PhD
Arch Surg. 1968;97(2):254-260. doi:10.1001/archsurg.1968.01340020118014.
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HOLMES, a British pathologist, used the term "villous tumor" in 1860, thus dividing the common benign epithelial tumors of the large bowel into two categories, the villous adenoma and the adenomatous polyp. The adenomatous polyp is typically a compact spheroid mass which is usually pedunculated; whereas, the villous adenoma is usually a soft sessile tumor without a pedicle. Grossly villous adenomata range in size from a nodule of 5 mm in diameter to a mass of enormous size which completely encircles the bowel. The tumor is spongy, reddish gray or tan in color, with a broad flat base. It is extremely soft and velvety and is made up of a large number of friable villi or finger-like projections joined at their bases in a pattern which is frequently lobulated. The entire lesion is usually covered by a thick viscid mucous. Microscopically, the surface is made up of multiple tiny villi

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