| Theme |
Reappraisal of Colorectal Protruded and Flat Lesions Which are Encountered During Endoscopy |
| Title |
Submucosal Carcinoid Tumors of Colon and Rectum |
| Author |
Kiyonori Kobayashi |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Miwa Sada |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Miyuki Mukae |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Taishi Ogawa |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Kaoru Yokoyama |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Wasaburou Koizumi |
Department of Gastroenterology, Kitasato University East Hospital |
| [ Summary ] |
In Japan, colorectal carcinoid tumors most commonly arise in the rectum, particularly the lower portion. Many lesions are asymptomatic and detected when they are 10 mm or less in diameter. Endoscopic examination typically reveals yellowish, submucosal tumors, often with dilated blood vessels on their surface. Endoscopic ultrasonography is useful to evaluate the depth of invasion. Tumor diameter is closely related to the risk of metastasis. Because tumors 10 mm or less in diameter are rarely associated with metastasis, local treatment such as endoscopic polypectomy is indicated if the depth of invasion does not extend beyond the submucosa and there is no evidence of enlarged lymph nodes observed with endoscopic ultrasonography. A two-channel colonoscopies are useful for performing endoscopic polypectomies. Surgical colectomy should be considered for tumors exceeding 10 mm in diameter. However, complications may lead to colostomies. The treatment of choice depends on the characteristics of individual lesions. |