TWO CASES OF RECTAL CARCINOID DETECTED BY ENDOSCOPIC POLYPECTOMY

Abstract

Two cases of rectal carcinoid detected by endoscopic polypectomy are reported. Case 1 is a 29-year-old female who complained of lower abdominal pain. Colonofiber-scopy demonstrated sessile polypoid lesion coverd with normal rectal mucosa. Endoscopic polypectomy was performed. The excised tumor was 5×5×5 mm in size. Microscopic examination of the specimen confirmed carcinoid tumor. Neither argentaffin nor argyro-phil reaction were positive. Electron microscopic examination revealed numerous round electron dense granules. Case 2 is a 54-year-old female who complained of anal bleeding. Barium enema showed polypoid lesion at the rectum. A yellowish sessile polypoid prominence was revealed endoscopically at the rectum. The tumor was removed by endoscopic polypectomy. The excised specimen measuring 14×14×10 mm in size, revealed his-tological features of carcinoid tumor. Both argentaffin and argyrophil reaction were positive. Pleomorphic electron dense granules were observed by electron microscopy. In this case residual tumor cells at the resected margin were suspected ; additional surgical treatment was done. We reviewed previous case reports of rectal carcinoid and stressed endoscopic polypectomy is a useful diagnostic procedure for rectal carcinoid. But it must be used discreetly as a therapeutics, because a few cases of rectal carcinoid with metastasis were reported among ones with a size under 10 mm or without invasion to muscularis propria.