Rectal carcinoid tumor: endoscopic ultrasonographic detection and endoscopic removal

Endoscopic submucosal dissection and preoperative assessment with endoscopic ultrasonography for the treatment of rectal carcinoid tumors

“…They reported that only tumor size was an independent significant factor in assessment of the malignant nature of rectal carcinoid tumors with multivariate analysis, although the findings of tumor size ([10 mm), depth of invasion (muscularis propria or beyond), central depression or ulceration, mitotic index ([2/10 high power field, HPF), vascular invasion, and Ki-67 labeling index ([2%) were useful predictive criteria. Because the size and depth of rectal carcinoid tumors could not be detected with conventional endoscopy, EUS was performed to determine whether these tumors are indicated for endoscopic treatment and was found to be useful for assessing the size and the depth of rectal carcinoid tumors [15][16][17].…”

Endoscopic Resection of Small Rectal Carcinoid Tumours Using an Aspiration Method with a Transparent Overcap

“…Among the patients with a tumour ≥ 2 cm in diameter, invasion of the muscularis propria was found in seven of the 12 patients not having metastasis and 52 of the 59 patients having metastasis at the time of resection. 7 In patients who underwent abdominoperineal resection, the 5-year survival rates were 100% among patients with a tumour < 2 cm in diameter, and 57% among patients with a tumour ≥ 2 cm in diameter. 5 Local resection, therefore, seems to be sufficient for small tumours, unless the tumours invade the muscle layer.…”

“…Endoscopic polypectomy has a limited role in removing submucosal tumours. 7,10 Lifting the mucosal layer from the submucosa by injecting saline within the submucosa has made it feasible to remove sessile tumours by endoscopic snare electroexcision. Koyama et al 4 reported the usefulness of double snare polypectomy for the successful resection of small rectal carcinoid tumours.…”

“…Recent developments in endoscopy have produced the possibility of endoscopic resection of small intestinal tumours. 7,8 Hence, critical assessment of the local invasion is required when endoscopic resection of a small rectal carcinoid tumour is considered. Ultrasonography is an essential tool for assessing the local invasion of the tumour.…”

“…Ultrasonography is an essential tool for assessing the local invasion of the tumour. 7,9 Carcinoid tumours are imaged as homogeneous hypoechoic masses, and the depth of invasion can generally be assessed accurately. Endoscopic polypectomy has a limited role in removing submucosal tumours.…”