Ran JX, Xu LB, Chen WW, Yang HY, Weng Y, Peng YM. Is lymphatic invasion of microrectal neuroendocrine tumors an incidental event?: A case report. World J Clin Cases 2023; 11(4): 859-865 [PMID: 36818613 DOI: 10.12998/wjcc.v11.i4.859]
Corresponding Author of This Article
Liang-Bi Xu, MA, Chief Physician, Endoscopy Center, Affiliated Hospital of Guizhou Medical University, No. 9 Beijing Road, Guiyang 550000, Guizhou Province, China. gzxlb@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jing-Xue Ran, Yan Weng, Yong-Mei Peng, Clinical Medical School, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Liang-Bi Xu, Wan-Wei Chen, Hao-Yi Yang, Endoscopy Center, Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Author contributions: Ran JX was responsible for writing the paper; Xu LB was responsible for patient treatment and study design; Chen WW and Yang HY were responsible for collecting and analyzing data; Weng Y and Peng YM were responsible for patient follow-up.
Supported byGuizhou Science and Technology Plan Project, No. ZK2022-General-443; and Science and Technology Fund of Guizhou Provincial Health and Health Commission, No. gzwkj2023-135.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and all accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang-Bi Xu, MA, Chief Physician, Endoscopy Center, Affiliated Hospital of Guizhou Medical University, No. 9 Beijing Road, Guiyang 550000, Guizhou Province, China. gzxlb@sina.com
Received: August 30, 2022 Peer-review started: August 30, 2022 First decision: December 9, 2022 Revised: January 2, 2023 Accepted: January 16, 2023 Article in press: January 16, 2023 Published online: February 6, 2023 Processing time: 159 Days and 17.1 Hours
Abstract
BACKGROUND
A rectal neuroendocrine tumor (rNET) is a malignant tumor originating from neuroendocrine cells. Currently, tumor size is the primary basis for assessing tumor risk.
CASE SUMMARY
This article reports the case of a 46-year-old male patient who underwent a colonoscopy that found a 3 mm rectal polypoid bulge. The pathological examination of a sample collected with biopsy forceps revealed a neuroendocrine tumor. Further endoscopic submucosal dissection rescue therapy was used. The presence of lymphatic vessels indicated that the tumor had infiltrated the negative resection margin. The lesion was located in the distal rectum near the anal canal. Therefore, to ensure the patient’s quality of life, follow-up observation was conducted after full communication with the patient. No tumor recurrence or distant metastasis has been found during the 13-mo follow-up after surgery.
CONCLUSION
Despite the presence of lymphatic invasion and extremely small diameter rNETs in our case, this phenomenon may not imply a higher risk of distant lymph node and organ metastasis.
Core Tip: Due to the heterogeneity and atypical symptoms of rectal neuroendocrine tumors, in the process of clinical diagnosis and treatment, it is not sufficient to judge the risk of tumor metastasis based only on tumor size and lymphovascular invasion. Therefore, during treatment, it is necessary to formulate an individualized plan, undertake close follow-up observation, and try to improve the quality of life and disease prognosis of patients while reducing the burden of treatment.
