Abstract
We report a case of rectal carcinoid which brought about rapid local recurrence and liver metastasis after the operation. A 69-year-old man was admitted with a complaint of bleeding at the time of evacuation. Malignant mass (type-3) was found endoscopically. Ultrasonograpy, CT scan and MR image showed lymphatic involvement without liver metastasis. A Miles' operation (D-2) was carried out. The tumor was invaded to prostate so deep that it was hard to dissect lesser pelvic cavity. The tumor was histologically diagnosed as rectal carcinoid, and got over muscle layer and invaded peri-rectal adipose tissue and local lymphnodes. Then he was discharged in 32nd POD in good condition. In 52nd POD, he was admitted to hospital again. At this time anal hard mass was recognized. MR image showed multiple nodular tumors in the anus part. And liver metastasis was recognized multiply in ultrasonography. He died of liver dysfunction and renal dysfunction in 61st POD. This report implicates that Miles' operation gives no survival advantage for patients with aggressive behavior of rectal carcinoid tumors.
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