Lessons of the month 2: McKittrick-Wheelock syndrome: Case report of a patient declining resection of a large villous adenoma.

McKittrick-Wheelock syndrome (MWS) is a rare cause of acute kidney injury and electrolyte depletion. It is driven by a secretory tumour or polyp of the distal large colon. Although rare, it is a diagnosis that must be considered in patients presenting with the above conditions. Treatment is with surgical resection of the offending growth. We present the case of a 70-year-old woman who presented multiple times with electrolyte depletion and acute kidney injury. The diagnosis of MWS was established and treatment options discussed. Surgical intervention was declined, and management consisted of patient education, the careful replacement of fluid and electrolytes and close monitoring of electrolytes and kidney function. After a short period as an inpatient, the patient went on to be discharged and, with regular follow-up, has managed to continue a normal life. © Royal College of Physicians 2020. All rights reserved.