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The prognosis of rectal carcinoid tumours

  • B. Teleky
  • F. Herbst
  • F. Längle
  • N. Neuhold
  • B. Niederle
Original Articles

Abstract

Carcinoid tumours of the rectum are very rare, and they may present sprecial therapeutic problems for the surgeon. Tumour size and muscle layer invasion are the two most important factors predicting their malignant potential. A series of 20 patients with carcinoid tumours of the rectum were reviewed. 16 tumours less than 2 cm in diameter had neither muscle layer invasion nor lymph node metastases, with the exception of one tumour. Four patients with tumours larger than 2 cm died from metastatic carcinoid. In order to plan operative management endoluminal ultrasound should be performed preoperatively. Rectal carcinoid tumours should be treated like carcinomas of the rectum if they are 2 cm or more in diameter or if they demonstrate muscularis propria invasion independent of tumour size.

Keywords

Carcinoma Lymph Node Internal Medicine Lymph Node Metastasis Tumour Size 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Les tumeurs carcinoïdes du rectum sont très rares et peuvent présenter des problèmes thérapeutiques particuliers pour le chirurgien. Le calibre de la tumeur et l'invasion des couches musculaires sont les deux facteurs les plus importants pour prévoir leur potentiel malin. Une série de 20 malades présentant une tumeur carcinoïde du rectum a été revue. Les 16 tumeurs de moins de 2 cm de diamètre ne présentaient ni invasion des couches musculaires, ni métastase lymphatique à l'exception d'une seule. 4 patients avec des tumeurs plus grandes que 2 cm sont morts de métastases carcinoïdes. En vue de planifier la conduite opératoire l'échographie endo-rectale devrait être pratiquée pré-opératoirement. Les tumeurs carcinoïde du rectum devraient être traitées comme des cancers du rectum si leur diamètre dépasse 2 cm où si elles démontrent une invasion de la musculaire propre, indépendamment de la taille de la tumeur.

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References

  1. 1.
    Godwin JD II (1975) Carcinoid tumors. An analysis of 2837 cases. Cancer 36:250–259Google Scholar
  2. 2.
    Naunheim KS, Zeitels J, Kaplan LE, Sugimoto J, Shen KL, Lee Ch, Strauß FS (1983) Rectal carcinoid tumors — treatment and prognosis. Surgery 94:670–676Google Scholar
  3. 3.
    Caldarola VT, Jackman RJ, Moertel CG, Dockerty MB (1964) Carcinoid tumors of the rectum. Am J Surg 107:844–849Google Scholar
  4. 4.
    Saltykow SL (1912) Über die Genese der „Karzinoiden Tumoren“ sowie der „Adenomyome” des Darmes. Beitr Path Anat 54:559–594Google Scholar
  5. 5.
    Brunschwig A (1933) Argentaffin tumor (Carcinoid) of the rectal colon. JAMA 100:1171–1172Google Scholar
  6. 6.
    Genre CF, Rath LM, Reed RJ (1971) Benign rectal carcinoid: a report of two patients with metastases to regional lymph nodes. Am J Clin Path 56:750–757Google Scholar
  7. 7.
    Orloff MJ (1971) Carcinoid tumors of the rectum. Cancer 28:175–180Google Scholar
  8. 8.
    Peskin GW, Orloff MJ (1959) A clinical study of 25 patients with carcinoid tumors of the rectum. Surg Gynecol Obstet 209:673–682Google Scholar
  9. 9.
    Tumacder IC, Horn RC, Eisenstein A, Arminski TC, Wilson GC, Lucas RJ (1986) Carcinoid tumours of the rectum: a review of 40 cases. Arch Surg 97:261–266Google Scholar
  10. 10.
    Burke M, Shepherd N, Mann CV (1987) Carcinoid tumours of the rectum and anus. Br J Surg 74:358–361Google Scholar
  11. 11.
    Shirouzu K, Morodomi T, Isomoto H, Yamauchi Y, Kakegawa T, Morimatsu M (1985) Small-cell carcinoma of the rectum. Clinicopathologic study. Dis Colon Rectum 28:434–439Google Scholar
  12. 12.
    Morton WA, Johnstone FRC (1965) Rectal carcinoids; 52:391–393Google Scholar
  13. 13.
    Bates HR (1962) Carcinoid tumours of the rectum. Dis Colon Rectum 5:270–281Google Scholar
  14. 14.
    Kaplan FL, Meier P (1958) Non parametric estimations from incomplete estimations. J Am Statist Ass 43:457–481Google Scholar
  15. 15.
    Mason AY (1976) Rectal cancer: the spectrum of selective surgery. Proc R Soc Med 69:237–244Google Scholar
  16. 16.
    Nicholls RJ, Mason AY, Morson BC, Dixon AK, Kelsey Fry I (1982) Clinical taging of rectal cancer. Br J Surg 69:404–409Google Scholar
  17. 17.
    Hildebrandt U, Feifel G (1985) Preoperative staging of rectal cancer by intrarectal ultrasound. Dis Colon Rectum 28:42–46Google Scholar
  18. 18.
    Saitoh N, Okui K, Sarashina H, Suzuki M, Arai T, Nunomura M (1986) Evaluation of echographic diagnosis of rectal cancer using intrarectal ultrasonic examination. Dis Colon Rectum 29:234–242Google Scholar
  19. 19.
    Beynon J, Foy DMA, Roe AM, Temple LN, Mortensen NJMcC (1986) Endoluminal ultrasound in the assessment of local invasion in rectal cancer. Br J Surg 73:474–477Google Scholar
  20. 20.
    Beynon J, Mortenson NJMcC, Foy DMA, Chancer JL, Virjee J, Goddard P (1986) Endorectal sonography: laboratory and clinical experience in Bristol. Int J Colorect Dis 1:201–226Google Scholar
  21. 21.
    Hildebrandt U, Feifel G, Schwarz HP, Scherr O (1986) Endorectal ultrasosund: instrumentation and clinical aspects. Int J Colorect Dis 1:203–207Google Scholar
  22. 22.
    Boscaini M, Masoni L, Montori A (1986) Transrectal ultrasonography: three years' experience. Int J Colorect Dis 1:208–211Google Scholar
  23. 23.
    Accarpio G, Scopinaro G, Claudiani F, Davini D, Mallarini G, Saitta S (1987) Experience with local rectal cancer excision in light of two recent preoperative diagnostic methods. Dis Colon Rectum 30:296–298Google Scholar
  24. 24.
    Candio GD, Mosca F, Campatelli A (1987) Endosonographic staging of rectal carcinoma. Gastrointestinal Radiol 12:289–295Google Scholar
  25. 25.
    Rifkin MD, Ehrlich SM, Marks G (1989) Staging of rectal carcinoma: prospective comparison of endorectal ultrasound and CT. Radiology 170:319–322Google Scholar
  26. 26.
    Orrom WJ, Wong WD, Rothenberger DA, Jensen LL, Goldberg SM (1990) Endorectal ultrasound in the preoperative staging of rectal tumors. Dis Colon Rectum 33:654–659Google Scholar
  27. 27.
    Milsom JW, Graffner H (1990) Intrarectal ultrasonography in rectal cancer staging and in the evaluation of pelvic disease. Ann Surg 212:602–606Google Scholar
  28. 28.
    Thompson GB, van Heerden JA, Martin JK Jr, Schutt AJ, Ilstrup DM, Carney JA (1985) Carcinoid tumors of the gastrointestinal tract: Presentation, management, and prognosis. Surgery 98:1054–1063Google Scholar
  29. 29.
    Fazio VW (1991) Curative local therapy of rectal cancer. Int J Colorect Dis 6:66–73Google Scholar
  30. 30.
    Dixon AK, Fry IK, Morson BC (1981) Preoperative computed tomography of carcinoma of the rectum. Br J Radiol 54:655–659Google Scholar
  31. 31.
    Grabbe E, Lierse W, Winkler R (1983) The perirectal fascia, morphology and use in staging of rectal carcinoma. Radiology 149:241–246Google Scholar
  32. 32.
    Freeny PC, Marks WM, Ryan JA, Bolen JW (1986) Colorectal carcinoma evaluation with CT. Preoperative staging and detection of postoperative recurrence. Radiology 158:347–353Google Scholar
  33. 33.
    Thompson WM, Halvorsen RA, Foster WL, Roberts L, Gibbon R (1986) Preoperative and postoperative CT staging of rectosigmoid carcinoma. Am J Radiology 146:703–710Google Scholar
  34. 34.
    Rifkin MD, Wechsler RJ (1986) A comparison of computed tomography and endorectal ultrasound in staging rectal cancer. Int J Colorect Dis 1:219–223Google Scholar
  35. 35.
    Churukian CJ, Schenk EA (1979) A modification of Pascual's argyrophil method. J Histotechnol 2:102–103Google Scholar
  36. 36.
    Sternberger LA, Hardt PH, Cuculis JJ (1970) The unlabeled antibody enzyme method of immunohistochemistry: Preparation and properties of soluble antigen-antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes. J Histochem Cytochem 18:315–333Google Scholar
  37. 37.
    Hsu SM, Raine L, Fanger H (1981) Use of avidin-biotin-peroxidase complex (ABC) in immunperoxidase techniques: a comparison between ABC and the unlabeled antibody (PAP) procedures. J Histochem Cytochem 29:577–586Google Scholar
  38. 38.
    Federspiel BH, Burke AP, Sobin LH, Shekitka KM (1990) Rectal and colonic carcinoids. Cancer 65:135–140Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • B. Teleky
    • 1
  • F. Herbst
    • 1
  • F. Längle
    • 1
  • N. Neuhold
    • 2
  • B. Niederle
    • 1
  1. 1.Department of Surgery IUniversity of Vienna, Medical SchoolViennaAustria
  2. 2.Institute of Clinical PathologyUniversity of Vienna, Medical SchoolViennaAustria

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