MINUTE CARCINOID (2mm) OF THE RECTUM WITH VASCULAR INVASION DEMANDED A LAPAROTOMIC RADICAL OPERATION -REPORT OF A CASE-

Abstract

We have experienced a case of minute carcinoid (2mm) of the rectum with vascular invasion demanded a laparotomic radical operation.
A 65-year-old man was admitted to the hospital because of a SMT in the rectum Rb which was diagnosed as carcinoid on January 24, 1997. There were previous histories of undergoing polypectomies 7 times for colorectal polyps since 57 of age. On admission hormone levels in the blood and urine were in normal range. On february 6, 1997, an excision of the rectal tumor was conducted through transanal endoscopic microsurgery (TEM). Pathologically, it was a 0.2×0.2cm carcinoid of sm, ly1 . v2, Ki67 (+), and PCNA (+) with negative surgical stumps. From these pathological findings, we determined that an additional operation was needed. On March 12, an abdominoperineal excision of rectum with D3 superior lymph nodes dissection was performed. Postoperative course was uneventful and the patient was discharged from the hospital on April 9.
This experience with the case has made us have a new understanding of that the malignancy of carcinoids should not be determined by the size of tumor and that we have to give careful consideration to select therapies.