Rectal Neuroendocrine of a Tumor with Only Lateral Lymph Node Metastases Treated by Laparoscopic Lateral Lymph Node Dissection

Abstract

A 57-year-old woman was seen at a local medical doctor for a discomfort of defecation. Colonoscopy was performed at the hospital and submucosal tumor was found in the Rb rectum. Endoscopic submucosal resection was performed and the resected specimen was histologically diagnosed as neuroendocrine tumor (NET; G1). She was admitted to our hospital for additional radical resection. CT and MRI showed swollen left lateral pelvic lymph nodes that were suspected as lymph nodes metastases. Laparoscopic super low anterior resection with left-side lateral pelvic lymph node dissection was performed. Resected lymph nodes were histologically diagnosed as metastases of NET. In this paper, we reviewed reported 4 cases of lateral pelvic lymph node metastasis of NET. Pre-operative CT or MRI examination is indispensable for the detection of lateral pelvic lymph node metastasis regardless of tumor size or macroscopic morphology. In cases of NET with lateral pelvic lymph node metastasis, better clinical outcome could be achieved by radical lateral lymph node dissection according to the treatment for rectal cancer.