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Pedunculated rectal carcinoid removed by endoscopic mucosal resection: a case report
Hisayuki Hamada1, Saburo Shikuwa, Chun-Yang Wen
1Institute for Clinical Research Center, WHO Collaborating Center for Reference and Research on Viral Hepatitis, National Nagasaki Medical Center, Japan.
World Journal of Gastroenterology
|December 12, 2003
Summary
A rare mushroom-shaped pedunculated rectal carcinoid tumor was identified in a patient presenting with rectal bleeding. This unusual presentation can challenge endoscopic diagnosis, highlighting the need for careful evaluation of such rare carcinoid tumors.
Area of Science:
- Gastroenterology
- Oncology
Background:
- Carcinoid tumors are typically submucosal nodules.
- Rectal carcinoid tumors present diagnostic challenges due to varied morphology.
Observation:
- A 40-year-old woman presented with rectal bleeding.
- Colonoscopy revealed a 13 mm mushroom-shaped pedunculated polyp in the rectum.
- Initial biopsy suggested adenocarcinoma, but histology confirmed a carcinoid tumor.
Findings:
- The pedunculated type of rectal carcinoid is rare, occurring in 2.4%–7.1% of cases.
- The tumor's pedunculated morphology mimicked other rectal polyps, complicating initial diagnosis.
- Endoscopic mucosal resection (EMR) was successfully performed.
Implications:
- The rare pedunculated morphology of rectal carcinoid tumors can lead to misdiagnosis during endoscopy.
- Management of rectal carcinoid tumors between 1 and 1.5 cm remains a subject of debate.
- While EMR is feasible, careful consideration of potential unexpected tumor behavior is crucial.