| Theme |
Current Topics on Anorectal Disorders |
| Title |
Carcinoid Tumor : Diagnosis and Treatment |
| Author |
Hiroyuki Imaeda |
Center for Diagnostic and Therapeutic Endoscopy, Keio University Hospital |
| Author |
Yasushi Iwao |
Center of Comprehensive and Progressive Medicine, Keio University Hospital |
| Author |
Nagamu lnoue |
Center of Comprehensive and Progressive Medicine, Keio University Hospital |
| Author |
Haruhiko Ogata |
Center for Diagnostic and Therapeutic Endoscopy, Keio University Hospital |
| Author |
Kaori Kameyama |
Department of Pathology, Keio University Hospital |
| Author |
Makio Mukai |
Department of Pathology, Keio University Hospital |
| Author |
Toshifumi Hibi |
Department of Internal Medicine, School of Medicine, Keio University |
| [ Summary ] |
In Japen, almost all colorectal carcinoid tumors are located in the rectum. Most of these invade the sub-mucosal layer. Since tumor size is increasing, tumors are invading deeper into the submucosal layer and the metastatic ratio has increased. It is important, for decisions on treatment and predictions for prognoses, to check the invasion depth of lesions and for metastasis before resection. Lesions less than 10 mm in diameter with submucosal invasion can be treated with endoscopic mucosal resection. However, additional surgery should be considered for lesions with lymphatic or venous invasion and remnants. For the lesions over 11 mm in diameter or with invasion into the muscularis propria, initial surgical operations with lymphadenectomy should be chosed. Radical operations with permanent colostomies should be performed for Rb lesions, however decisions on treatment should be made based on the informed consent of patients. Establishment of localized treatment for rectal carcinoid tumors is expected in the future. |