Carcinoid tumors of the rectum
Carcinoid tumors of the rectum
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直肠类癌
DOI：
10.1002/1097-0142(197107)28:1
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发表时间：
1971
期刊：
影响因子：
6.2
通讯作者：
M. Orloff
中科院分区：
文献类型：
--
作者：
M. Orloff
HI!$ REPORT CONCERNS OUR EXPERIENCE T w i t h 3:3 patients who had carcinoid tumors of the rectum treated more than 5 years ago. Carcinoid tumors arise irom one or another of :several types of enterochromaffin cells and have clinical, histochemical, and biochemical differences related to their sites of origin. Alithough metastatic carcinoids arising from both foregut and midgut structures secrete a vai-iety of potent humoral agents in addition to serotonin, no rectal carcinoid has been found to produce a physiologically active secretory product or to cause the malignant carcinoid spectrum. Rectal carcinoids occur without predilection regarding sex or race in patients who most frequently are in their sixth and seventh decades. The lesion usually appears through the sigmoidoscope as a movablle, submucosal nodule with intact overlying epithelium. Multiple carcinoids and associated malignant tumors of other types are unusual. Many rectal carcinoids are asymptomatic, but some are associated with mild rectal bleeding due to ulceration, and with constipation. Carcinoids of the rectum present particular problems in therapy because micro’scopically they have the cytologic featurles of a benign tumor, yet a significant number are malignant in their behavior. Our experience indicates that the two findings which indicate malignancy are tumor invasion. into or beyond the muscularis of the bowel on microscopic examination of a biopsy, and a tumor size of 2 cm or more in diameter. Acccrrcrling to these criteria, 390/, of our patients had malignant carcinoids. As we proposed previously, tumors which do not invade muscle and are smaller than 2 cm in diameter should be treated by local excision, while larger lesions or those that invade the muscularis require radical extirpation, usually in the form of an abdominoperineal resection.
