Andrew Y Wang1, Nuzhat A Ahmad. 1. Gastroenterology Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Abstract
PURPOSE OF REVIEW: To provide an updated review of the diagnosis, management, and treatment of rectal carcinoid tumors, with special emphasis on minimally invasive surgical techniques to treat localized disease. RECENT FINDINGS: Carcinoids are morphologically and biologically heterogeneous neuroendocrine tumors that have malignant potential, and are most commonly found in the gastrointestinal tract. The incidence of all carcinoids appears to be increasing, which may reflect improved diagnostic modalities. The rectum is the third most common location for gastrointestinal carcinoids. Recent data have suggested that rectal carcinoids are over-represented in Black and Asian populations. The survival rate for patients with rectal carcinoids is superior to that of carcinoids found elsewhere in the gastrointestinal tract. Tumor size in rectal carcinoids is predictive of metastasis and can reliably guide management. Review of recent literature demonstrates good evidence that localized rectal carcinoids are amenable to local resection. SUMMARY: With widespread colorectal cancer screening, heightened awareness, and improved diagnostic modalities, the incidence of rectal carcinoids should continue to increase. There is evidence that convincingly demonstrates that patients with rectal carcinoids less than 2 cm in diameter, localized to the mucosa or submucosa, may be safely and effectively removed via minimally invasive resection.
PURPOSE OF REVIEW: To provide an updated review of the diagnosis, management, and treatment of rectal carcinoid tumors, with special emphasis on minimally invasive surgical techniques to treat localized disease. RECENT FINDINGS: Carcinoids are morphologically and biologically heterogeneous neuroendocrine tumors that have malignant potential, and are most commonly found in the gastrointestinal tract. The incidence of all carcinoids appears to be increasing, which may reflect improved diagnostic modalities. The rectum is the third most common location for gastrointestinal carcinoids. Recent data have suggested that rectal carcinoids are over-represented in Black and Asian populations. The survival rate for patients with rectal carcinoids is superior to that of carcinoids found elsewhere in the gastrointestinal tract. Tumor size in rectal carcinoids is predictive of metastasis and can reliably guide management. Review of recent literature demonstrates good evidence that localized rectal carcinoids are amenable to local resection. SUMMARY: With widespread colorectal cancer screening, heightened awareness, and improved diagnostic modalities, the incidence of rectal carcinoids should continue to increase. There is evidence that convincingly demonstrates that patients with rectal carcinoids less than 2 cm in diameter, localized to the mucosa or submucosa, may be safely and effectively removed via minimally invasive resection.