[A case of 7 mm rectal carcinoid with lymph node metastasis]

A 67-year-old man was admitted to our hospital because of fecal occult blood. Colonoscopy revealed a 7 mm rectal submucosal tumor, which was diagnosed as rectal carcinoid on biopsy. No metastasis was found on abdominal CT scan. We performed an endoscopic mucosal resection (EMR), but the vertical margin of the specimen was positive. We therefore performed a laparoscopic low anterior resection. There was no residue of carcinoid tumor in the resected specimen, but metastasis to a pararectal lymph node was found. In general, endoscopic treatment is performed for SM invasive rectal carcinoid less than 10 mm in diameter. However, several cases of lymph node metastasis with small carcinoid tumor have been reported. Therefore, the possibility of lymph node metastasis must be considered in patients with rectal carcinoid.