多発肝転移を伴ったと考えられた9mmの直腸カルチノイド腫瘍の1例

抄録

A 77-year-old man was referred to our hospital for workup of multiple liver metastases. The endoscopic view showed the submucosal tumor (SMT) of 9mm in a diameter, which was located in the rectum. There was no depression of surface on the SMT. EUS imaging showed a hypoechoic mass in the third layer. Biopsy specimen revealed carcinoid. An abdominal ultrasonograpy and CT demonstrated multiple masses of the liver. As there was no metastasis in other organs with further examinations, we suspected the liver tumors were metastases from the carcionid. Rectal carcinoid tumor less than 10mm in diameter with liver metastasis is rare. When SMT has a depression of central part in the tumor, the rate of metastasis become higher compared to that without the sign. Eighteen cases of rectal carcinoid tumors less than 10 mm that caused liver metastasis have been reported in the Japanese literature.
We should be aware that even the rectal carcinoid less than 10 mm in diameter without depression in central part has the possibility of the distant metastasis.