Report of 5 Surgically Treated Cases of Rectal Carcinoid Less than 20 mm in diameter

Fuminori Ono, Ryuji Nakamura, Kohji Itoh, Noriko Kondoh and Noboru Noto

Department of Surgery, Towada City Central Hospital

We report 5 patients surgically treated rectal carcinoid less than 20 mm in diameter. Only 1 had a tumor less than 10 mm in diameter, and we performed an endoscopic polypectomy followed by transsacral sleeve resection of the rectum to examine tumor residue. In 4 patients with tumors more than 10mm in diameter, we conducted low anterior resection of the rectum and applied everted rectal stump in 3. Invasion was confined to the submucosal layer in 4 and to the muscular layer in 1. Tumors 13 to 18 mm in diameter had a central depression or ulceration in addition to lymph node metastasis, 1 of which had no vascular invasion. Since the risk of lymph node metastasis is relatively high in patients with tumors more than 11mm in diameter, we recommend radical surgery with lymph node dissection, even if no vascular invasion is noted histologically. This is especially important if the tumor has a central depression.

Key words
rectal carcinoid, lymph node metastasis

Reprint requests
Fuminori Ono Department of surgery, Towada City Central Hospital 14-8 Nishinijuniban-cho, Towada, 034-0093 JAPAN

Accepted
September 25, 2002

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