Case Report
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 15, 2003; 9(12): 2870-2872
Published online Dec 15, 2003. doi: 10.3748/wjg.v9.i12.2870
Pedunculated rectal carcinoid removed by endoscopic mucosal resection: a case report
Hisayuki Hamada, Saburo Shikuwa, Chun-Yang Wen, Hajime Isomoto, Kazuhiko Nakao, Kosei Miyashita, Manabu Daikoku, Koji Yano, Masahiro Ito, Yohei Mizuta, Long-Dian Chen, Zhao-Min Xu, Ikuo Murata, Shigeru Kohno
Hisayuki Hamada, Saburo Shikuwa, Kosei Miyashita, Manabu Daikoku, Koji Yano, Masahiro Ito, Institute for Clinical Research Center, WHO Collaborating Center for Reference and Research on Viral Hepatitis, National Nagasaki Medical Center, Nagasaki, Japan, Kubara 2-1001-1, Omura 852-8562, Nagasaki, Japan
Chun-Yang Wen, Department of Molecular Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
Chun-Yang Wen, Long-Dian Chen, Zhao-Min Xu, Department of Digestive Disease, Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
Hajime Isomoto, Kazuhiko Nakao, Yohei Mizuta, Shigeru Kohno, Second Department of Internal Medicine, School of Medicine, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8523 Japan
Ikuo Murata, Department of Pharmacotherapeutics, Nagasaki University, Graduate School of Biomedical Sciences, 1-14 Bunkyo-machi, Nagasaki 852-8521, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Chun-Yang Wen M.D Ph.D, Department of Molecular Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan. cywen518@net.nagasaki-u.ac.jp
Telephone: +81-95-849-7107 Fax: +81-95-849-7108
Received: August 6, 2003
Revised: September 10, 2003
Accepted: October 23, 2003
Published online: December 15, 2003
Abstract

Carcinoid tumors generally appear as yellow/gray or tan submucosal nodules. We experienced a case of pedunculated rectal carcinoid showing a mushroom-like appearance. The case was a forty years old woman who was admitted to our hospital due to rectal bleeding. Colonoscopy revealed a pedunculated polyp presenting a mushroom-shaped appearance measuring 13 mm in diameter in the rectum. The histological diagnosis of specimens obtained by biopsy was adenocarcinoma and transanal ultrasonography revealed the tumor localization within the submucosal layer in the rectum. Endoscopic mucosal resection (EMR) was performed. Histopathological examination established the diagnosis of carcinoid tumor in the rectum. Frequencies of the pedunculated type in rectal carcinoids were reported to be 2.4% to 7.1% in the literature. Because of its rarity, pedunculated configuration may confuse the endoscopic diagnosis of carcinoids. Treatment for carcinoids of 1 to 1.5 cm in size remains controversial. Although such tumors are technically respectable by EMR, careful attention must be paid in dealing with these tumors because there may be unexpected behaviors of the tumors.

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