“…Also owing to the fact that diagnosis was rarely achieved preoperatively, histology did not play a major role in surgical management strategy in most cases. Historically, tumor size, already known to be related with tumor metastatic potential, led the surgeon in the choice between radical surgery or local excision and the latter was generally preferred in the case of low‐risk tumors (less than 2.0 cm in maximum diameter) 51,52 . However, already in 1984, Walsh et al retrospective analysis showed that local excision of smooth muscle neoplasms of the rectum were associated with a high local recurrence rate, despite the fact that long‐term survival was similar to the one reported after radical surgery and lymphadenectomy 3 .…”