A 58-year-old woman visited our hospital with the complaint of bleeding on defecation. Colorectal endoscopy showed a 10-mm submucosal tumor with a slight central depression. Histopathological examination of biopsy specimens led to the diagnosis of rectal neuroendocrine tumor (NET) . Thoracoabdominal computed tomography did not reveal lymph node or distant metastasis. We performed endoscopic submucosal dissection. Immunohistopathological examination of the resected tumor led to the diagnosis of synaptophysin-positive, chromogranin-negative, CD56-positive grade 2 NET with a positive resection margin. Therefore, we additionally performed laparoscopic-assisted low anterior resection and lymphadenectomy. No remaining tumor was found in the resected ESD scar. Metastasis was identified in one (No. 251) of the 35 dissected lymph nodes. Her postoperative course was good, and she was discharged on the 12th hospital day. We report a case of a small rectal carcinoid tumor with lymph node metastasis with a literature review.
