Title: McKittrick-Wheelock syndrome presenting with an uncommon symptom
in a 70 year-old-woman
Authors: Konosuke Nakaji1, Yuuki
Mizuno1
1 Endoscopy Center, Aishinkai Nakae Hospital, 30-1
Funadokoro, Wakayama-shi, Wakayama, 640-8461, Japan
Corresponding author contact information: Konosuke Nakaji,
parupurikopui@yahoo.co.jp
Key words: McKittrick-Wheelock syndrome, uncommon symptom,
Key Clinical Message:
We present a unique image from a case of McKittrick-Wheelock syndrome
(MWS) that was detected in an elderly woman. She presented with an
uncommon symptom of shortness of breath. Our observations will raise
awareness about the diagnosis of MWS.
Electrolyte disorders due to the colonic villous tumor was first
reported by McKittrick and Wheelock in 1954, and it has been known as
McKittrick-Wheelock syndrome (MWS) [1]. Its common symptoms are
general fatigue, weakness, and loss of consciousness. We present a rare
case of shortness of breath as a symptom of MWS.
A 70-year-old woman was admitted to our hospital for shortness of
breath. On laboratory examinations, she presented severe hyponatremia,
hypochloremia, impaired glucose tolerance, and renal failure. An
abdominal computed tomography showed a large protruded tumor in the
rectum. Colonoscopy revealed a mucus-rich villous tumor in the lower
rectum (Figure A). Since there were no other examinations that explained
electrolyte disorders, she was diagnosed with MWS. Subsequently, a
laparoscopic low anterior resection of the villous tumor was performed.
Histological examination of the resected specimens revealed tubular
adenocarcinoma in papillary adenocarcinoma (Figure B). The patient’s
postoperative course was good, and her symptom and the electrolyte
abnormalities improved. This report aims to raise the physician’s
awareness about a rare symptom of the rectal villous tumor.
CONFLICT OF INTEREST
None declared.
AUTHOR CONTRIBUTIONS
MY and NK: took part in the care of the patient. NK: wrote the
manuscript. NK: reviewed and supervised the manuscript. All authors
approved the final manuscript.
REFERENCE
Ohara Y. 2015. Electrolyte depletion syndrome (McKittrick-Wheelock
syndrome) successfully treated by endoscopic submucosal dissection.
Clin J Gastroenterol. 8(5): 280-4
FIGURE LEGEND
Figure A: Colonoscopy showed a mucus-rich villous tumor in the lower
rectum (yellow arrow heads).
Figure B: Histopathological findings of resected specimens showing
papillary adenocarcinoma (left red arrow) with tubular adenocarcinoma
components (right red arrow).