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Proximal Rectal Carcinoid

PeggieL
Posts: 1
Joined: Feb 2011

Hi, I haven't been able to talk to anyone who has experience with a rectal carcinoid. My doctor tells me not to worry it's not really cancer its "cancer like". I was diagnosed after a polyp was found on colonoscopy. The polyp was 10mm in size and in the proximal rectum on the front wall. There are positive margins so I need additional surgery. The are going to do an interoperative colonoscopy and burn tumor out. Dr. says because its small I don't neeed any other testing and once the tumor is out I will need nothing else. Has anyone else had experience with this ?

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

A CARCINOID TUMOR IN A
RECTAL POLYP.........

THE TERM "carcinoid" was first introduced by
Oberndorferl in 1907 to describe this peculiar
tumor of the appendix. Since that time the tumor
has been found in the stomach, gall-bladder, small
and large bowel, and Meckel's diverticulum. The
behavior of the tumor varies with its location.
In the appendix it is more often benign, and only
4% are said to be malignant.2 In the small bowel
20-40% are found to be malignant and here it is
very often multiple.3' 4 Spread is to the regional
lymphatics, the liver, and adjacent peritoneum.
The clinical picture of malignant carcinoid syndrome
is too familiar to require comment.
Carcinoid tumors of the rectum behave much
like those of the appendix, and are relatively
benign. They occasionally metastasize to the liver,
and they do recur. The tumor may present as
a nodule, polyp, annular constriction, or as a
plaque. Most rectal carcinoids are asymptomatic.
The treatment of the benign tumor is adequate
local excision. For the malignant form, or for large
annular growths and those which recur, a more
radical operation is required. The following case
is reported in which a benign carcinoid tumor
occurred in an adenomatous polyp of the rectum..........

Mrs. M., 38 years old, when first seen gave a history
of a lump that had been felt in her rectum on a routine
examination. She had no complaints, and functional
enquiry revealed no rectal symptoms. On physical
examination she was found to be healthy and with
no pathological findings apart from the rectal ones.
On digital examination one could feel a mobile, limabean-
shaped nodule on the right side in the lower
rectum. This felt extremely hard to the touch and
there was no blood on the examining finger. Proctoscopic
examination revealed the nodule to be situated
at the tip of a polyp which was approximately one
inch long. The polyp was situated at nine o'clock
(patient in lithotomy) about one inch above the
anorectal junction. The base of the polyp was clean
and there was no induration or bleeding. Sigmoidoscopy
and barium enema did not reveal further polyps.
At operation the growth was removed by excising
the base. A primary closure of the mucosal defect
was then carried out. On splitting the specimen, the
tip of the polyp contained a hard white nodule. There
did not appear to be any involvement of the pedicle.
The pathologist reported an adenomatous polyp of
the rectum containing an apparently benign carcinoid
tumor.

sounds as if most found are benign, but to be on the safe side I would have blood tests done for maybe a year just to keep on the safe side...always "better to know than to wonder"....buzz

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