Abstract
We report 5 patients surgically treated rectal carcinoid less than 20mm in diameter. Only 1 had a tumor less than 10mm in diameter, and we performed an endoscopic polypectomy followed by transsacral sleeve resection of the rectum to examine tumor residue. In 4 patients with tumors more than 10mm in diameter, we conducted low anterior resection of the rectum and applied everted rectal stump in 3. Invasion was confined to the submucosal layer in 4 and to the muscular layer in 1. Tumors 13 to 18mm in diameter had a central depression or ulceration in addition to lymph node metastasis, 1 of which had no vascular invasion. Since the risk of lymph node metastasis is relatively high in patients with tumors more than 11mm in diameter, we recommend radical surgery with lymph node dissection, even if no vascular invasion is noted histologically. This is especially important if the tumor has a central depression.
