Takenoya Takashi, Yoshikawa Takahisa, Yamada Taketo, Kawaida Miho, Kondo Aya, Asada Yusuke, Oto Ippei, Yabe Nobushige, Osumi Koji, Murai Shinji
Dept. of Surgery, Ogikubo Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1437-1439.
A 40-year-old man visited our hospital with rectal submucosal tumors measuring 5 mm and the 7 mm as detected by colonoscopy, following which an endoscopic submucosal resection was performed. Pathological examination revealed that the tumors was neuroendocrine tumor(NET); the tumor measuring 5 mm was NET G1 without lymphatic and venous invasion, while the 7 mm size was NET G2 with venous invasion but without lymphatic invasion. Lymph node and distant metastasis were not observed by computed tomography. Informed consent was obtained and he agreed to undergo additional rectal resection. Laparoscopic low anterior resection was performed and pathological examination enabled a diagnosis of rectal neuroendocrine tumor with regional lymph node metastases(T1a, N1, M0, Stage ⅢB[Union for International Cancer Control 8th edition]). Post-surgery, he was followed up for 3 years, without recurrence. This report suggests that the determination of treatment plan for rectal neuroendocrine tumor measuring less than 1 cm in diameter should be done carefully.
一名40岁男性因结肠镜检查发现直肠黏膜下肿瘤，大小分别为5毫米和7毫米，前来我院就诊，随后进行了内镜下黏膜切除术。病理检查显示肿瘤为神经内分泌肿瘤（NET）；5毫米大小的肿瘤为NET G1，无淋巴管和静脉侵犯，而7毫米大小的为NET G2，有静脉侵犯但无淋巴管侵犯。计算机断层扫描未发现淋巴结和远处转移。获得了知情同意，他同意接受额外的直肠切除术。进行了腹腔镜低位前切除术，病理检查确诊为直肠神经内分泌肿瘤伴区域淋巴结转移（T1a，N1，M0，ⅢB期[国际癌症控制联盟第8版]）。术后对他进行了3年随访，无复发。本报告提示，对于直径小于1厘米的直肠神经内分泌肿瘤，治疗方案的确定应谨慎进行。
