Pedunculated rectal carcinoid removed by endoscopic mucosal resection: A case report

Carcinoid tumors generally appear as yellow/gray or tansubmucosal nodules.We experienced a case of pedunculatedrectal carcinoid showing a mushroom-like appearance.Thecase was a forty years old woman who was admitted to ourhospital due to rectal bleeding.Colonoscopy revealed apedunculated polyp presenting a mushroom-shapedappearance measuring 13 mm in diameter in the rectum.The histological diagnosis of specimens obtained by biopsywas adenocarcinoma and transanal ultrasonography revealedthe tumor localization within the submucosal layer in therectum.Endoscopic mucosal resection(EMR)was performed.Histopathological examination established the diagnosis ofcarcinoid tumor in the rectum.Frequencies of thepedunculated type in rectal carcinoids were reported to be2.4 % to 7.1% in the literature.Because of its rarity,pedunculated configuration may confuse the endoscopicdiagnosis of carcinoids.Treatment for carcinoids of 1 to1.5 cm in size remains controversial.Although such tumorsare technically respectable by EMR,careful attention mustbe paid in dealing with these tumors because there may beunexpected behaviors of the tumors.