脈管侵襲を伴った小さな直腸NETの1例

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  • A case of small rectal neuroendocrine tumor with lymphovascular invasion

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A 55-year old man consulted medical doctor because fecal occult blood test was positive. Colonoscopy shows a rectal tumor in the lower rectum (Rb,DL3cm) . Pathological findings shows neuroendocrine tumor (NET) . In our hospital, colonoscopy and EUS was performed. Tumor size was 6 mm in diameter. Metastasis was not detected in abdomino-pelvic CT and MRI. We performed endoscopic submucosal resection (ESD) . Resected specimen reveals vascular invasion with Victoria Blue stain. So we decided additional operation. We performed laparoscopic assisted super low anterior resection. We have succeeded complete resection and no recurrence in 6 months after operation. Rectal NET less than 10 mm in diameter with metastasis is not very rare (9.7%) . If there are lymphovascular invasion was positive in specimen of endoscopic resection, it should be indicated additional resection. Because it is difficult that lymph nodes metastasis were detected with CT scan.

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