PURPOSE
This study was designed to define the indications of endoscopic polypectomy for rectal carcinoid tumors and evaluate the diagnostic value of endoscopic ultrasonography.
METHODS
A total of 66 rectal carcinoid tumors treated at our hospital were analyzed histopathologically to clarify risk factors for metastasis. The depth of invasion was determined for 52 lesions examined by endoscopic ultrasonography, and the value of endoscopic ultrasonography for deciding whether a lesion is indicated for endoscopic polypectomy was assessed.
RESULTS
None of the 57 lesions measuring ≤ 10 mm in diameter invaded the muscularis propria or had metastasis. Of nine lesions with a diameter of ≥ 11 mm, five invaded the muscularis propria and four had metastasis. A central depression was found in three of the lesions with metastasis. The depth of invasion of 49 lesions examined by endoscopic ultrasonography was limited to the submucosa; 3 lesions invaded the muscularis propria. The depth of invasion of all lesions was correctly diagnosed by endoscopic ultrasonography. Ninety-six percent of the lesions that had submucosal invasion with narrowing of the upper two-thirds of the third layer (submucosa) as evaluated by endoscopic ultrasonography could be completely resected by endoscopic polypectomy.
CONCLUSIONS
Rectal carcinoid tumors that satisfy the following three conditions are indicated for local resection, including endoscopic polypectomy: a maximum diameter of ≤ 10 mm, no invasion of the muscularis propria, and no depression or ulceration in the lesion. Endoscopic ultrasonography also is useful for estimating the depth of invasion of rectal carcinoid tumors and for determining whether endoscopic polypectomy is indicated.
Similar content being viewed by others
REFERENCES
H Ishikawa K Imanishi T Otani S Okuda M Tatsuta S Ishiguro (1989) ArticleTitleEffectiveness of endoscopic treatment of carcinoid tumors of the rectum Endoscopy 21 133–5 Occurrence Handle2743944 Occurrence Handle1:STN:280:BiaA3crksFU%3D
K Matsui T Iwase M Kitagawa (1993) ArticleTitleSmall, polypoid-appearing carcinoid tumors of the rectum: clinicopathological study of 16 cases and effectiveness of endoscopic treatment Am J Gastroenterol 88 1949–53 Occurrence Handle1:STN:280:ByuD2Mnjt10%3D Occurrence Handle8237948
S Higaki M Nishiaki N Mitani H Yanai M Tada K Okita (1997) ArticleTitleEffectiveness of local endoscopic resection of rectal carcinoid tumors Endoscopy 29 171–5 Occurrence Handle9201465 Occurrence Handle1:STN:280:ByiA2crgvFw%3D
MB Kimmey RW Martin RC Hagitt KY Wang DW Franklin FE Silverstein (1989) ArticleTitleHistological correlates of gastrointestinal ultrasound images Gastroenterology 96 433–41 Occurrence Handle1:STN:280:BiaD1M7ptlI%3D Occurrence Handle2642877
IM Modlin A Sandor (1997) ArticleTitleAn analysis of 8305 cases of carcinoid tumors Cancer 79 813–29 Occurrence Handle10.1002/(SICI)1097-0142(19970215)79:4<813::AID-CNCR19>3.0.CO;2-2 Occurrence Handle1:STN:280:ByiC2sjhs1w%3D Occurrence Handle9024720
MJ Orloff (1971) ArticleTitleCarcinoid tumors of the rectum Cancer 28 175–80 Occurrence Handle1:STN:280:CS2D3MrpsVE%3D Occurrence Handle5110628
JD Godwin (1975) ArticleTitleCarcinoid tumors—an analysis of 2837 cases Cancer 36 560–9 Occurrence Handle1157019
J Soga (1994) ArticleTitleCarcinoid tumors: a statistical analysis of a Japanese series of 3126 reported and 1180 autopsy cases Acta Med Biol 42 87–102
KS Naunheim J Zeitels EL Kaplan et al. (1983) ArticleTitleRectal carcinoid tumors – treatment and prognosis Surgery 94 670–6 Occurrence Handle1:STN:280:BiuD3MfhtFM%3D Occurrence Handle6623366
J Soga (1997) ArticleTitleCarcinoids of the rectum: an evaluation of 1271 reported cases Surg Today 27 112–9 Occurrence Handle9017986 Occurrence Handle1:STN:280:ByiC2s%2FmvVY%3D
HR Bates (1966) ArticleTitleCarcinoid tumors of the rectum: a statistical review Dis Colon Rectum 9 90 Occurrence Handle5908773
JG Morgan C Marks D Hearn (1974) ArticleTitleCarcinoid tumors of the gastrointestinal tract Ann Surg 180 720–7 Occurrence Handle1:STN:280:CSqD38nosFM%3D Occurrence Handle4421375
BH Federspiel AP Burke LH Sobin KM Shekitka (1990) ArticleTitleRectal and colonic carcinoids—a clinicopathologic study of 84 cases Cancer 65 135–40 Occurrence Handle1:STN:280:By%2BD1M%2Fjs1E%3D Occurrence Handle2293859
AB Jetmore JE Ray JB Gathright KM McMullen TC Hicks AE Timmcke (1992) ArticleTitleRectal carcinoids: the most frequent carcinoid tumor Dis Colon Rectum 35 717–25 Occurrence Handle1:STN:280:By2A2MvkvVc%3D Occurrence Handle1643994
B Teleky F Herbst F Langle N Neuhold B Niederle (1992) ArticleTitleThe prognosis of rectal carcinoid tumours Int J Colorect Dis 7 11–4 Occurrence Handle1:STN:280:By2B28fnt10%3D
AN Koura GG Giacco SA Curley JM Skibber BW Feig LM Ellis (1997) ArticleTitleCarcinoid tumors of the rectum—effect of size, histopathology, and surgical treatment on metastasis free survival Cancer 79 1294–8 Occurrence Handle9083149 Occurrence Handle1:STN:280:ByiB3snksFc%3D
Y Araki H Isomoto K Shirouzu (2001) ArticleTitleClinical efficacy of video-assisted gasless transanal endoscopic microsurgery (TEM) for rectal carcinoid tumor Surg Endosc 15 402–4 Occurrence Handle11395824 Occurrence Handle1:STN:280:DC%2BD38%2Fht1yhsA%3D%3D
H Yoshikane Y Tsukamoto Y Niwa et al. (1993) ArticleTitleCarcinoid tumors of the gastrointestinal tract: evaluation with endoscopic ultrasonography Gastrointest Endosc 39 375–83 Occurrence Handle10.1016/S0016-5107(93)70109-1 Occurrence Handle8514069 Occurrence Handle1:STN:280:ByyB1M3osFY%3D
H Fujishima T Misawa A Maruoka M Yoshinaga Y Chijiwa H Nawata (1993) ArticleTitleRectal carcinoid tumor: endoscopic ultrasonographic detection and endoscopic removal Eur J Radiol 16 198–200 Occurrence Handle8508835 Occurrence Handle1:STN:280:ByyB1critVU%3D
K Shirouzu H Isomoto T Kakegawa M Morimatsu (1990) ArticleTitleTreatment of rectal carcinoid tumors Am J Surg 160 262–5 Occurrence Handle2393053 Occurrence Handle1:STN:280:By%2BA28rhsVQ%3D
M Schindl B Niederle M Hafner et al. (1998) ArticleTitleStage-dependent therapy of rectal carcinoid tumors World J Surg 22 628–34 Occurrence Handle9597939 Occurrence Handle1:STN:280:DyaK1c3mtVagsg%3D%3D
K Kobayashi N Yamada M Igarashi T Katsumata K Saigenji Y Naitou (1994) ArticleTitleEndoscopic studies of small rectal carcinoid tumor (less than 10 mm in diameter)—especially, effectiveness of endoscopic ultrasonography and 2 channel scope Prog Dig Endosc 45 101–5
H Iishi M Tatsuta H Yano H Narahara K Iseki S Ishiguro (1996) ArticleTitleMore effective endoscopic resection with a two-channel colonoscope for carcinoid tumors of the rectum Dis Colon Rectum 39 1438–9 Occurrence Handle8969673 Occurrence Handle1:STN:280:ByiC38vltVc%3D
Y Imada-Shirakata M Sakai T Kajiyama et al. (1996) ArticleTitleEndoscopic resection of rectal carcinoid tumors using aspiration lumpectomy Endoscopy 28 34–8
Author information
Authors and Affiliations
Additional information
Published online: 28 January 2005.
Reprints are not available.
About this article
Cite this article
Kobayashi, K., Katsumata, T., Yoshizawa, S. et al. Indications of Endoscopic Polypectomy for Rectal Carcinoid Tumors and Clinical Usefulness of Endoscopic Ultrasonography. Dis Colon Rectum 48, 285–291 (2005). https://doi.org/10.1007/s10350-004-0765-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10350-004-0765-y