Rectal adenocarcinoma resection specimen with an incidental carcinoid in the resection margin

Zhou,Jie; Teng,Xiaodong

doi:10.3892/ol.2014.1933

Rectal adenocarcinoma resection specimen with an incidental carcinoid in the resection margin

Authors:
- Jie Zhou
- Xiaodong Teng
View Affiliations

Affiliations: Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
Published online on: March 4, 2014 https://doi.org/10.3892/ol.2014.1933
Pages: 1661-1664

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Three cases of incidental carcinoid tumors have been identified in the surgical margin of rectal adenocarcinoma resection specimens. In all cases the rectal carcinoids exhibited low‑risk features, such as a tumor size <10 mm, no muscularis propria invasion and no lymph node involvement. No further excision was conducted and the three cases were followed up for 38, 26 and 14 months, respectively. No regional or distant rectal carcinoid recurrence was identified. Occasionally this is inevitable in order to achieve a positive resection margin for the microcarcinoid during the surgical treatment of another malignancy. However, such carcinoids are usually low‑risk and behave less aggressively than same‑site adenocarcinomas. Thus, it appears reasonable to avoid further excision in patients who are undergoing a rectal adenocarcinoma resection that exhibits a positive margin for low‑risk carcinoid tumor.

View Figures

View References

1	Shields CJ, Tiret E and Winter DC; International Rectal Carcinoid Study Group. Carcinoid tumors of the rectum: a multi-institutional international collaboration. Ann Surg. 252:750–755. 2010. View Article : Google Scholar
2	Yoon SN, Yu CS, Shin US, et al: Clinicopathological characteristics of rectal carcinoids. Int J Colorectal Dis. 25:1087–1092. 2010. View Article : Google Scholar
3	Mani S, Modlin IM, Ballantyne G, Ahlman H and West B: Carcinoids of the rectum. J Am Coll Surg. 179:231–248. 1994.
4	Modlin IM, Lye KD and Kidd M: A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 97:934–959. 2003. View Article : Google Scholar
5	Gerstle JT, Kauffman GL Jr and Koltun WA: The incidence, management, and outcome of patients with gastrointestinal carcinoids and second primary malignancies. J Am Coll Surg. 180:427–432. 1995.
6	Landry CS, Brock G, Scoggins CR, et al: A proposed staging system for rectal carcinoid tumors based on an analysis of 4701 patients. Surgery. 144:460–466. 2008. View Article : Google Scholar
7	Konishi T, Watanabe T, Kishimoto J, Kotake K, Muto T and Nagawa H; Japanese Society for Cancer of the Colon and Rectum. Prognosis and risk factors of metastasis in colorectal carcinoids: results of a nationwide registry over 15 years. Gut. 56:863–868. 2007.
8	Soga J: Early-stage carcinoids of the gastrointestinal tract: an analysis of 1914 reported cases. Cancer. 103:1587–1595. 2005. View Article : Google Scholar
9	Fujimoto Y, Oya M, Kuroyanagi H, Ueno M, Akiyoshi T, Yamaguchi T and Muto T: Lymph-node metastases in rectal carcinoids. Langenbecks Arch Surg. 395:139–142. 2010. View Article : Google Scholar
10	Fahy BN, Tang LH, Klimstra D, Wong WD, Guillem JG, Paty PB, Temple LK, Shia J and Weiser MR: Carcinoid of the rectum risk stratification (CaRRs): a strategy for preoperative outcome assessment. Ann Surg Oncol. 14:1735–1743. 2007. View Article : Google Scholar
11	Hassan MM, Phan A, Li D, Dagohoy CG, Leary C and Yao JC: Risk factors associated with neuroendocrine tumors: A U.S.-based case-control study. Int J Cancer. 123:867–873. 2008. View Article : Google Scholar
12	Hemminki K and Li X: Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden. Cancer. 92:2204–2210. 2001. View Article : Google Scholar : PubMed/NCBI
13	Naunheim KS, Zeitels J, Kaplan EL, et al: Rectal carcinoid tumors - treatment and prognosis. Surgery. 94:670–676. 1983.PubMed/NCBI
14	Soga J: Carcinoids of the rectum: an evaluation of 1271 reported cases. Surg Today. 27:112–119. 1997. View Article : Google Scholar
15	Tichansky DS, Cagir B, Borrazzo E, et al: Risk of second cancers in patients with colorectal carcinoids. Dis Colon Rectum. 45:91–97. 2002. View Article : Google Scholar
16	Schneider C, Wittekind C and Köckerling F: An unusual incidence of carcinoid tumors and secondary malignancies. Chirurg. 66:607–611. 1995.(In German).
17	Li AF, Hsu CY, Li A, Tai LC, Liang WY, Li WY, Tsay SH and Chen JY: A 35-year retrospective study of carcinoid tumors in Taiwan: differences in distribution with a high probability of associated second primary malignancies. Cancer. 112:274–283. 2008.
18	Oberg K: Expression of growth factors and their receptors in neuroendocrine gut and pancreatic tumors, and prognostic factors for survival. Ann NY Acad Sci. 733:46–55. 1994. View Article : Google Scholar
19	Modlin IM, Kidd M, Latich I, et al: Current status of gastrointestinal carcinoids. Gastroenterology. 128:1717–1751. 2005. View Article : Google Scholar : PubMed/NCBI
20	Ramage JK, Ahmed A, Ardill J, et al; UK and Ireland Neuroendocrine Tumour Society. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut. 61:6–32. 2012. View Article : Google Scholar
21	Anthony LB, Strosberg JR, Klimstra DS, et al; North American Neuroendocrine Tumor Society (NANETS). The NANETS consensus guidelines for the diagnosis and management of gastrointestinal neuroendocrine tumors (nets): well-differentiated NETS of the distal colon and rectum. Pancreas. 39:767–774. 2010. View Article : Google Scholar
22	Ramage JK, Goretzki PE, Manfredi R, et al; Frascati Consensus Conference participants. Consensus guidelines for the management of patients with digestive neuroendocrine tumours: well-differentiated colon and rectum tumour/carcinoma. Neuroendocrinology. 87:31–39. 2008. View Article : Google Scholar
23	Seow-Cheoen F and Ho J: Tiny carcinoids may be malignant. Dis Colon Rectum. 36:309–310. 1993. View Article : Google Scholar
24	Kwaan MR, Goldberg JE and Bleday R: Rectal carcinoid tumors: review of results after endoscopic and surgical therapy. Arch Surg. 143:471–475. 2008. View Article : Google Scholar
25	Moore JR, Greenwell B, Nuckolls K, et al: Neuroendocrine tumors of the rectum: a 10-year review of management. Am Surg. 77:198–200. 2011.PubMed/NCBI
26	Koura AN, Giacco GG, Curley SA, et al: Carcinoid tumors of the rectum: effect of size, histopathology, and surgical treatment on metastasis free survival. Cancer. 79:1294–1298. 1997. View Article : Google Scholar
27	Sippel RS and Chen H: Carcinoid tumors. Surg Oncol Clin N Am. 15:463–478. 2006. View Article : Google Scholar