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World J Gastrointest Endosc. May 16, 2023; 15(5): 368-375
Published online May 16, 2023. doi: 10.4253/wjge.v15.i5.368
Rectal neuroendocrine tumours and the role of emerging endoscopic techniques
Eoin Keating, Gayle Bennett, Michelle A Murray, Sinead Ryan, John Aird, Donal B O'Connor, Dermot O'Toole, Conor Lahiff
Eoin Keating, Gayle Bennett, Conor Lahiff, Department of Gastroenterology, Mater Misericordiae University Hospital, Dublin 7, Ireland
Eoin Keating, Gayle Bennett, Michelle A Murray, John Aird, Conor Lahiff, School of Medicine, University College Dublin, Dublin 4, Ireland
Michelle A Murray, National Lung Transplant Unit, Mater Misericordiae University Hospital, Dublin 7, Ireland
Sinead Ryan, John Aird, Department of Pathology, Mater Misericordiae University Hospital, Dublin 7, Ireland
Donal B O'Connor, Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland
Donal B O'Connor, Dermot O'Toole, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
Dermot O'Toole, Department of Clinical Medicine and Gastroenterology, St. James Hospital, Dublin 8, Ireland
Author contributions: Keating E designed and drafted the original manuscript and reviewed all subsequent and final drafts. Ryan S and Aird J, curated the pathological specimen and provided pathological comment. Bennett G, Murray. M, O’Connor D and O’Toole D reviewed the draft and final manuscripts. Lahiff C designed and reviewed the original manuscript and all subsequent drafts, including the final draft.
Conflict-of-interest statement: The authors declare no conflict of interests for this mini-review article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eoin Keating, MBChB, MRCP, Doctor, Department of Gastroenterology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland. eoinkeating@mater.ie
Received: February 3, 2023
Peer-review started: February 3, 2023
First decision: March 15, 2023
Revised: March 23, 2023
Accepted: April 21, 2023
Article in press: April 21, 2023
Published online: May 16, 2023
Abstract

Rectal neuroendocrine tumours represent a rare colorectal tumour with a 10 fold increased prevalence due to incidental detection in the era of colorectal screening. Patient outcomes with early diagnosis are excellent. However endoscopic recognition of this lesion is variable and misdiagnosis can result in suboptimal endoscopic resection with subsequent uncertainty in relation to optimal long-term management. Endoscopic techniques have shown particular utility in managing this under-recognized neuroendocrine tumour.

Keywords: Rectal neuroendocrine tumour, Carcinoid, Endoscopic mucosal resection, Endoscopic submucosal dissection, Knife-assisted snare resection

Core Tip: Rectal neuroendocrine tumours (r-NETs) are increasingly detected during colorectal screening. Endoscopists may not accurately distinguish r-NETs from other polyps and inadvertent resection attempts result in significant post resection challenges. r-NETs have an unpredictable metastasis pattern, requiring appropriate pre-resection assessment. Accurate endoscopic assessment and resection provides an effective option in the management of r-NETs.