Transanal endoscopic microsurgery: The first attempt in treatment of rectal amyloidoma

Abstract

Localized amyloidosis is characterized by amyloid protein deposition restricted to one organ or tissue without systemic involvement. Gastrointestinal manifestations of localized amyloidoma are unusual, which makes amyloidoma restricted to the rectum a very rare diagnosis requiring a high index of suspicion. We present a rare account for rectal amyloidoma with an unusual presentation of obstructive symptoms and its treatment using a sophisticated surgical modality, transanal endoscopic microsurgery (TEM), which resulted in complete excision of the lesion without hospitalization and complications. The successful treatment for this rectal amyloidoma using TEM emphasizes the need to broaden its application in the treatment of various rectal lesions while preserving organ function and decreasing recurrence.

Keywords: Transanal endoscopic microsurgery, Transanal endoscopic microsurgery, Amyloidoma, Localized amyloidosis, Rectal amyloidoma

Core tip: This case represents the first transanal endoscopic microsurgery (TEM) approach for full-thickness excision to treat organ restricted amyloidosis of the rectum, a very rare entity requiring high suspicion for diagnosis and treatment. Although TEM is the preferred modality to treat early rectal cancers and rectal adenomas, it should also be considered for other benign and non-advanced rectal lesions, such as localized amyloidoma. TEM is a less invasive procedure that provides lower morbidity and mortality by decreasing incidence of local recurrence and complications while preserving rectal continence and function.