Effectiveness of endoscopic treatment of carcinoid tumors of the rectum.

The effectiveness of endoscopic polypectomy in the treatment of carcinoid tumors of the rectum was investigated. Flat tumors of less than 1.5 cm in the largest diameter, of normal or yellow color, consisting histologically of solid nodular nests or trabecular or ribbon-like structures were "early" tumors, in which the tumor cells were confined to the mucosa and submucosa, and did not involve deeper layers. Eight patients with "early" carcinoids were treated by endoscopic polypectomy. Subsequently, two of them were submitted to surgery, while the other six were followed-up endoscopically. Histological examination of the specimens obtained at operation showed no evidence of residual tumor cells at the polypectomy site. Endoscopic follow-up studies also failed to reveal local recurrence in any of the patients during the average observation period of 1.3 years. The wall of the rectum was significantly thicker than that of the sigmoid colon, so that deeper local excision was possible. These findings indicate that even though "early" carcinoid tumors of the rectum showed submucosal invasion, they were completely cured by local endoscopic excision.