Review article: the investigation and management of rectal neuroendocrine tumours

Abstract

The long-term tumour biology of small rectal neuroendocrine tumours remains unclear. There is uncertain impact from bowel cancer screening programmes on rectal neuroendocrine tumour incidence, morbidity and mortality. Referral to neuroendocrine tumour centres for patients with locally advanced disease or metastatic disease is recommended.

Colorectal Neuroendocrine Neoplasms: Areas of Unmet Need

“…Rectal NETs have been reviewed extensively in the literature recently [2, 3] with data that does not need repeating, but it is noted that the incidence of rectal NET is rising and is higher in certain ethnic groups. These tumours are unlike any other NETs in that they are usually small, low-grade and can often be completely removed at endoscopy.…”

“…For those with a primary rectal NET, the cross-sectional imaging protocol would be similar to that in patients with rectal cancer. Primary tumour staging is performed with magnetic resonance imaging (MRI), which is standard practice for T stage but may not be so accurate for N stage [2, 8], although some centres prefer rectal ultrasound to assess the relation of the tumour to the different layers of the bowel wall [9]. The diagnosis of perirectal lymph node (LN) metastases may be difficult because of the limited penetration of the ultrasound, which is insufficient to examine the whole extent of the perirectal space.…”

Neuroendocrine tumor of the rectum detected incidentally: A case report

“…Eğer tümörde muskularis propria tutulumu, lenf nodu tutulumu, 2 cm den büyük tümör çapı, yüksek grade (grade 3), invazyon varlığı yada ileri evre (Evre 2-4)'den en az birinin olması halinde total mezorektal eksizyonla beraber abdominoperineal ya da low anterior rezeksiyon önerilmektedir (3). Sonuç olarak; rektal NET nadiren de olsa karşımıza çıkabilmektedir.…”

“…Sürveyans analizlerinde gastrointestinal NET'lerin son yıllarda insidansının arttığı görülmektedir. Rektal NET'ler yıllık tüm NET'lerin %17.1'ini oluşturur (3). Aynı kolon kanseri gibi standart tedavisi rezeksiyondur.…”

Trans‐anal full‐thickness endoscopic resection of a rectal neuroendocrine neoplasm performed with a TEO® (Karl Storz microsurgery device) and laparoscopic indocyanine‐green‐guided lymphatic sampling – a video vignette

“…Endoscopic resection is indicated for rectal NENs measuring less than 10 mm in diameter without muscular invasion and peripheral lymph node metastasis. More extensive tumours should undergo complete surgical resection of the organ and lymphadenectomy . As a consequence of the low mitotic count in the excised liver lesion and the discrete nature of the rectal lesion we decided to perform a minimally invasive procedure as a first approach.…”