Korean J Med.  2014 Oct;87(4):415-423. 10.3904/kjm.2014.87.4.415.

Diagnosis and Treatment of Rectal Neuroendocrine Tumor

• Shin HD

• KMID: 2269216
• DOI: http://doi.org/10.3904/kjm.2014.87.4.415

Abstract

Rectal neuroendocrine tumors (NETs) are not uncommon. Recently, the incidence of rectal NETs has increased markedly due to the widespread use of screening colonoscopy. Most rectal NETs detected incidentally are asymptomatic and at an early stage at diagnosis. Typical NETs < 10 mm in size and confined to the submucosal layer can be resected completely using various endoscopic treatments. These NETs have a good prognosis. However, not all NETs necessarily have good prognoses; those > 10 mm in size, with ulceration or depression, muscularis invasion seen on endoscopic ultrasonography (EUS), lymphovascular invasion, or a high mitotic index histologically are associated with metastasis. Generally, NETs < 10 mm can be treated endoscopically, while those > 20 mm should be resected surgically. The treatment of NETs between 10 and 20 mm is controversial. For these, it is necessary to choose an effective, safe primary resection method to ensure complete resection and to perform a careful histological examination of the resected tissue.

Keyword

Rectum; Neuroendocrine tumor; Endoscopic treatment; Prognosis

MeSH Terms

Colonoscopy
Depression
Diagnosis*
Endosonography
Incidence
Mass Screening
Mitotic Index
Neoplasm Metastasis
Neuroendocrine Tumors*
Prognosis
Rectum
Ulcer