Endoscopic Resection of a Rectal Carcinoid Tumor with an Esophageal Variceal Ligation Device Report of a Case and Literature Review

Abstract

Rectal carcinoid tumors are rarely reported in Taiwan. Surgical resection is usually considered for a large tumor because of the malignant potential. In dealing with a carcinoid tumor smaller than 2 cm, endoscopic treatment is possible and less invasive than surgery. Endoscopic submucosal resection with a ligation device (ESMR-L) for rectal carcinoid tumors was first reported by Ono et al in 2003. In his series, the maximal size of resected rectal carcinoid tumor was less than 1 cm. Although this is a convenient and safe method, the size of treatable tumors was limited because of the size of his device. We report here a 71 year old man whose chief complaint was constipation for years and tennesmus for one month. Colonoscopy showed a submucosal tumor at 5 cm above the anal verge, measuring about 1.1 cm in size. A biospy revealed carcinoid tumor. ESMR-L was performed smoothly. No evidence of local recurrence, distant metastasis, nor carcinoid syndrome was found during 23 months follow up.