Clinical Gastroenterology Vol.21 No.10(7)

Theme Neuroendocrine Tumor of the Gastrointestinal Tract
Title Biology and Diagnosis of Colorectal Carcinoids
Publish Date 2006/09
Author Yasuhiro Satoh Department of Endoscopy, The Jikei University School of Medicine
Author Shoichi Saitoh Department of Endoscopy, The Jikei University School of Medicine
Author Hiroshi Arakawa Department of Endoscopy, The Jikei University School of Medicine
Author Masahiro Ikegami Department of Pathology, The Jikei University School of Medicine
Author Hisao Tajiri Department of Endoscopy, The Jikei University School of Medicine / Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine
[ Summary ] In Japan, colorectal carcinoids are most often found in the lower rectum. On endoscopic image, typical carcinoids look like submucosal tumors with smooth surfaces and a yellowish color. They are found mainly in the submucosal layer, and endoscopic ultrasonography (EUS) shows submucosal low echoic lesions with clear borders. They are apt to be uneven on the surface, have nonuniform internal echoic patterns with unclear borders, and display invasion beyond the muscularis propria, while enlarging. In addition, metastasis may be suspected with these findings. Although the metastasis of small lesions less than 10 mm in diameter is rare, it has been reported that nearly 60 percent of the lesions over 20 mm metastasize to other organs. On the basis of these features, we selected endoscopic mucosal resection (EMR) as first-line treatment for carcinoids, when there was no suspicion of metastasis.
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