Primary tumour arising in an isolated ureter

A case of transitional-cell papilloma in an isolated ureter is presented. Noteworthy features are the interval of 40 years between division of the ureter and presentation of the tumour, the gross extent of the tumour, and the method of presentation as a large cystic swelling in the left flank.

Villous tumours of the rectum associated with severe fluid and electrolyte disturbance

Two cases of villous tumour of the rectum associated with severe electrolyte disturbance leading to renal failure are presented.

Evidence is produced to show that electrolyte loss is general rather than selective and certainly not confined to potassium.

The ratio of sodium to potassium lost in rectal fluid is of the order of 3–4 : 1.

Correction of sodium deficiency, acidosis, and hypovolaemia by the intravenous route is of paramount importance.

Total correction of potassium deficiency in this way is neither practicable nor necessary but particular care should be taken to maintain plasma potassium levels during correction of metabolic acidosis.

Operative removal of the tumour should await restoration of electrolyte and fluid balance.