Rectal Carcinoid Tumor

Approximately 50% of rectal carcinoids are asymptomatic and found on routine endoscopy. Symptomatic patients usually present with rectal bleeding, pain, or constipation. The carcinoid syndrome is rare. The size of the primary lesion correlates closely with the probability of metastases, which occur in less than 5% of tumors measuring less than 1 cm, but in the majority of lesions greater than 2 cm.

Tumors less than 1 cm comprise two thirds of rectal carcinoid tumors and are successfully treated with local excision. The management of tumors measuring 1-2 cm is controversial. Although most tumors of this size can be managed with local excision, several authors have suggested that the presence of muscular invasion, symptoms at diagnosis, or ulceration are poor prognostic factors that warrant more extensive surgical procedures. Tumors measuring greater than 2 cm have traditionally been managed with low anterior resection or abdominoperineal resection.

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