Background: Carcinoid tumor of rectum is relatively uncommon lesion with malignant potential, representing 17-27% of gastrointestinal tract carcinoid. It is known to originate in enterochromaffin cell of the mucosa. It tend to invade muscularis mucosa and to develop to submucosal tumor. Since the majority of tumors are discoverd as a small lesion and the malignant risk are not always be uniform due to size, it is often clinically difficult to choose between endoscopic local resection and surgery. The selection of rectal carcinoid tumor treatment is determined by invasion depth and the presence of metastasis. The recent development of EUS has allowed detailed information of tumor in the invasion depth and local metastasis. In this study, we describe the clinical utility of EUS in selecting the management of the rectal carcinoid tumor. Material and Methods: Total 8 patients with rectal carcinoid tumor diagnosed by means of colonoscopy and EUS from 1993 to 1997 were included in this study. There were five men and three women whose ages ranged from 22 to 60 years, mean 45 years. The two patients complained of rectal bleeding. None had specific symptoms of carcinoid. The treatment modality of all tumors were selected by EUS before resection. We examamined histologic feature after resection of tumors in order to the effectiveness of EUS. Results: Case Age Sex Size (mm) EUS depth Histology Procedure Resection Follow up outcome (month) 1 43 M 5 m sm EE complete 16 2 42 M 10 sm sm EE complete 13 3 53 M 12 mp mp*EE complete 8 4 60 F 8 sm sm EE complete 37 5 47 M 17 mp mp SR complete 42 6 40 F 5 sm sm EE complete 48 7 56 M 6 sm sm EE complete 20 8 22 F 8 sm sm EE complete 5*patient refused surgery m:mucosa sm:submucosa pm:muscularis propria EE: endoscopic excision SR:surgical resection Conclusions: EUS is considered to be helpful in evaluating the malignant behavior of rectal carcinoid tumor. The selection based on the EUS findings is available in the choice of treatment for rectal carcinoid tumor.
|Publication status||Published - 1998 Dec 1|
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