A CASE OF RECTAL CARCINOID TUMOR 13 mm IN DIAMETER WITH LYMPH NODE METASTASIS

Abstract

A 64-year-old woman was admitted to the hospital because of unpleasant feeling in her anal region. digital examination revealed an elastic hard tumor on the lateral wall of the rectum. Barium enema and colonoscopy revealed a semipeduculated polypoid lesion 13mm in diameter with a central depression in the rectum. Endoscopic ultrasonography revealed the tumor limited with in the submucous layer. In this case, a possibility of malignancy could not be reled out because of central depression. So a low anterior resection with lymph nodes dissection was performed. Histologically, the tumor was confined to the submucous layer, and pararectal lymph node metastasis was observed.
Her postoperative course has been good without recurrence for 13 months after discharge.
Only 17 cases of rectal carcinoid which is smaller than 20mm in size and is confined to the submucous layer have been reported in the Japanese literarure so far. We must take a careful attitude to select therapies of the disease in case of central depression and vascular invasion, even if the tumor is small size.