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Abnormal Polyp in Rectum showing Carcinoid
I just had a colonoscopy and the doctor found a polyp and burned it off and sent it for testing. He told my husband that he found a polyp and burned it off and nothing looked abnormal. But when the test came back it said it was a abnormal Polyp showing Carcinoid. Can you please tell me what this means? I recieved the results in a letter from the doctor and he wants me to schedule an appointment within the next 7 days to discuss the next step. I have tried doing research on line to find out what this is....can you please give me some information on this? I have had lots of problems and systems in the past and present to include: ovarion cycst, diaherah, stomach pain& cramps, nausea, can't sleep, tired, moody, ect..
I am going thru the same confusion. I also have a carcinoid rectal tumor found during a colonoscopy. Get same confusing information. but this may help....It is CANCER , it is malignant but carcinoid tumors are slow growng and generally stand alone tumors. In other words have not spread beyond the tumor itself so once removed it is gone.
The only area of concern is depth of tumor...has it pentrated colon wall..where they cannot get at and remove all of it.
So i too am going thru beginning stages of trying to find out. next appointment is in a few days to see how it will be removed
The only area of concern is depth of tumor...has it pentrated colon wall..where they cannot get at and remove all of it.
So i too am going thru beginning stages of trying to find out. next appointment is in a few days to see how it will be removed
I go to the surgoen on Monday. Here is checking to see if the tumor is past the colon wall.
I got a call from the doctor today and they removed the other day is carcinoid, so now they are sending me to a surgeon to go back in to make sure there is no more and that the place that was removed isn't beyond the colon wall. I am starting to get really worried at this point. As I am really unsure of what is going on. Everything I ready says that carcinoid is cancerous but the doctors are say they are benign is that right? I am really confussed. I am hoping they are benign and that would mean they are not cancer correct? Starting to wonder if I should get another opinion. I am waiting on a call from the nurse as the doctor wants the surgeon to go in in the next week.
More than likely, they did miss them the first time. That is what happened to me. One gastro found one and when I went to MD Anderson, they found 2 more. Since they are experts in this field, it is not uncommon for them to find things other doctors overlook.
Ok went back yesterday for them to check to make sure they got the tumor and they found 2 more places. Not sure what is going on, have to wait for the test reports to come back to find out what the next step is. Is it possible they missed them 2 on the first one or could they really grow that fast in less than 3 weeks?
Ok, I went back to the doctor and now they are doing a urine test and doing another colonoscopy to ensure they got all of the tumor. It was a carcinoid tumor and at this point don't know much, but have a better understanding of what it is.
GO TO GOOGLE AND PUT IN "CARCINOID POLYP" AND IT COMES UP WITH A LOT OF WEBSITES DISCUSSING THIS. GOOD LUCK AND I HOPE THIS HELPS!
Carcinoid tumors generally appear as yellow/gray or tan
submucosal nodules.We experienced a case of pedunculated
rectal carcinoid showing a mushroom-like appearance. The
case was a forty years old woman who was admitted to our
hospital due to rectal bleeding. Colonoscopy revealed a
pedunculated polyp presenting a mushroom-shaped
appearance measuring 13 mm in diameter in the rectum.
The histological diagnosis of specimens obtained by biopsy
was adenocarcinoma and transanal ultrasonography revealed
the tumor localization within the submucosal layer in the
rectum. Endoscopic mucosal resection (EMR) was performed.
Histopathological examination established the diagnosis of
carcinoid tumor in the rectum. Frequencies of the
pedunculated type in rectal carcinoids were reported to be
2.4 % to 7.1 % in the literature. Because of its rarity,
pedunculated configuration may confuse the endoscopic
diagnosis of carcinoids. Treatment for carcinoids of 1 to
1.5 cm in size remains controversial. Although such tumors
are technically respectable by EMR, careful attention must
be paid in dealing with these tumors because there may be
unexpected behaviors of the tumors.
Hamada H, Shikuwa S, Wen CY, Isomoto H, Nakao K, Miyashita
K, Daikoku M, Yano K, Ito M, Mizuta Y, Chen LD, Xu ZM, Murata
I, Kohno S. A case of pedunculated rectal carcinoid removed by
endoscopic mucosal resection. World J Gastroenterol 2003; 9
(12): 2870-2872
http://www.wjgnet.com/1007-9327/9/2870.asp
INTRODUCTION
Carcinoid tumors characteristically appear as yellow/gray or
tan submucosal nodules, but they are occasionally polypoid
or sessile. However, there have been few reports describing a
pedunculated type of carcinoid. We presented here an
extremely rare case with a pedunculated rectal carcinoid
showing a mushroom-like appearance, and referred to the
diagnosis and treatment of this rare tumor.
CASE REPORT
A 40 years old woman was admitted to our hospital due to
rectal bleeding. Physical examination and laboratory data
including serum tumor markers and hormones such as urinary
5-hydroxyindoleacetic acid (5-HIAA) were normal. Barium
enema contrast examination showed a fungiform polyp in
the rectum. Colonoscopy revealed a pedunculated polyp
presenting a mushroom-shaped appearance in the rectum
(Figures 1A, B). There was a hemispherical protrusion with
a shallow central erosion in the top, surrounded by a marked
mucosal bulge of the edge. Magnifying endoscopy
(OLYMPUS CF-type XQ240ZI, Olympus, Tokyo, Japan)
revealed no absence of the pit pattern in the center and
enlarged pits at the edge, corresponding to the non-structure
type of the pit pattern classification proposed by Kudo et al[1]
(Figure 1C). Endoscopic ultrasonography (EUS), using a
miniature probe (12-20 Hz) with a water-filling method,
demonstrated a homogeneous hypoechoic mass, but the
structure deeper than the third layer of the rectal wall was
unclear (Figure 2). Therefore, we employed a soft-balloon
technique using an ultrasonic probe with a balloon filled with
deaerated water, which provided a clear ultrasonographic
picture of the deeper part of the rectum. Judging from findings
on EUS, abdominal computed tomography and chest
roentgenography, there were no signs of metastasis in the
regional lymph nodes or distant organs. Histology of the
biopsy specimens suggested an adenocarcinoma, yielding a
diagnosis of polypoid type of early rectal cancer. The depth
of mural invasion was estimated to be limited to the
submucosa by magnifying endoscopy and EUS. After an
injection of saline in the submucosa, the lesion was excised
by EMR. Macroscopically, the lesion was located in the
submucosal layer. The mass was white-yellowish and solid,
measuring 13 mm in diameter (Figure 3). Microscopically,
the tumor was composed of small uniform cells, arranged in
small nests and cords and with an anastomosing ribbon-like
pattern in the submucosal layer (Figure 4). There were no
atypical histopathologic features such as mitosis or nuclear
atypism. Histochemically, the tumor cells possessed an
argyrophil but not an argentaffin nature. Immunohistologically,
the tumor cells were positive for neuron specific enolase
(NSE) and chromogranin A, but were negative for p53 and
Ki67. These findings established the diagnosis of carcinoid
tumor in the rectum.
DISCUSSION
Carcinoid tumors are enigmatic slow growing malignancies
Carcinoid tumors generally appear as yellow/gray or tan
submucosal nodules.We experienced a case of pedunculated
rectal carcinoid showing a mushroom-like appearance. The
case was a forty years old woman who was admitted to our
hospital due to rectal bleeding. Colonoscopy revealed a
pedunculated polyp presenting a mushroom-shaped
appearance measuring 13 mm in diameter in the rectum.
The histological diagnosis of specimens obtained by biopsy
was adenocarcinoma and transanal ultrasonography revealed
the tumor localization within the submucosal layer in the
rectum. Endoscopic mucosal resection (EMR) was performed.
Histopathological examination established the diagnosis of
carcinoid tumor in the rectum. Frequencies of the
pedunculated type in rectal carcinoids were reported to be
2.4 % to 7.1 % in the literature. Because of its rarity,
pedunculated configuration may confuse the endoscopic
diagnosis of carcinoids. Treatment for carcinoids of 1 to
1.5 cm in size remains controversial. Although such tumors
are technically respectable by EMR, careful attention must
be paid in dealing with these tumors because there may be
unexpected behaviors of the tumors.
Hamada H, Shikuwa S, Wen CY, Isomoto H, Nakao K, Miyashita
K, Daikoku M, Yano K, Ito M, Mizuta Y, Chen LD, Xu ZM, Murata
I, Kohno S. A case of pedunculated rectal carcinoid removed by
endoscopic mucosal resection. World J Gastroenterol 2003; 9
(12): 2870-2872
http://www.wjgnet.com/1007-9327/9/2870.asp
INTRODUCTION
Carcinoid tumors characteristically appear as yellow/gray or
tan submucosal nodules, but they are occasionally polypoid
or sessile. However, there have been few reports describing a
pedunculated type of carcinoid. We presented here an
extremely rare case with a pedunculated rectal carcinoid
showing a mushroom-like appearance, and referred to the
diagnosis and treatment of this rare tumor.
CASE REPORT
A 40 years old woman was admitted to our hospital due to
rectal bleeding. Physical examination and laboratory data
including serum tumor markers and hormones such as urinary
5-hydroxyindoleacetic acid (5-HIAA) were normal. Barium
enema contrast examination showed a fungiform polyp in
the rectum. Colonoscopy revealed a pedunculated polyp
presenting a mushroom-shaped appearance in the rectum
(Figures 1A, B). There was a hemispherical protrusion with
a shallow central erosion in the top, surrounded by a marked
mucosal bulge of the edge. Magnifying endoscopy
(OLYMPUS CF-type XQ240ZI, Olympus, Tokyo, Japan)
revealed no absence of the pit pattern in the center and
enlarged pits at the edge, corresponding to the non-structure
type of the pit pattern classification proposed by Kudo et al[1]
(Figure 1C). Endoscopic ultrasonography (EUS), using a
miniature probe (12-20 Hz) with a water-filling method,
demonstrated a homogeneous hypoechoic mass, but the
structure deeper than the third layer of the rectal wall was
unclear (Figure 2). Therefore, we employed a soft-balloon
technique using an ultrasonic probe with a balloon filled with
deaerated water, which provided a clear ultrasonographic
picture of the deeper part of the rectum. Judging from findings
on EUS, abdominal computed tomography and chest
roentgenography, there were no signs of metastasis in the
regional lymph nodes or distant organs. Histology of the
biopsy specimens suggested an adenocarcinoma, yielding a
diagnosis of polypoid type of early rectal cancer. The depth
of mural invasion was estimated to be limited to the
submucosa by magnifying endoscopy and EUS. After an
injection of saline in the submucosa, the lesion was excised
by EMR. Macroscopically, the lesion was located in the
submucosal layer. The mass was white-yellowish and solid,
measuring 13 mm in diameter (Figure 3). Microscopically,
the tumor was composed of small uniform cells, arranged in
small nests and cords and with an anastomosing ribbon-like
pattern in the submucosal layer (Figure 4). There were no
atypical histopathologic features such as mitosis or nuclear
atypism. Histochemically, the tumor cells possessed an
argyrophil but not an argentaffin nature. Immunohistologically,
the tumor cells were positive for neuron specific enolase
(NSE) and chromogranin A, but were negative for p53 and
Ki67. These findings established the diagnosis of carcinoid
tumor in the rectum.
DISCUSSION
Carcinoid tumors are enigmatic slow growing malignancies
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