Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2023; 11(4): 859-865
Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.859
Is lymphatic invasion of microrectal neuroendocrine tumors an incidental event?: A case report
Jing-Xue Ran, Liang-Bi Xu, Wan-Wei Chen, Hao-Yi Yang, Yan Weng, Yong-Mei Peng
Jing-Xue Ran, Yan Weng, Yong-Mei Peng, Clinical Medical School, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Liang-Bi Xu, Wan-Wei Chen, Hao-Yi Yang, Endoscopy Center, Affiliated Hospital of Guizhou Medical University, Guiyang 550000, Guizhou Province, China
Author contributions: Ran JX was responsible for writing the paper; Xu LB was responsible for patient treatment and study design; Chen WW and Yang HY were responsible for collecting and analyzing data; Weng Y and Peng YM were responsible for patient follow-up.
Supported by Guizhou Science and Technology Plan Project, No. ZK2022-General-443; and Science and Technology Fund of Guizhou Provincial Health and Health Commission, No. gzwkj2023-135.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and all accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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: Liang-Bi Xu, MA, Chief Physician, Endoscopy Center, Affiliated Hospital of Guizhou Medical University, No. 9 Beijing Road, Guiyang 550000, Guizhou Province, China. gzxlb@sina.com
Received: August 30, 2022
Peer-review started: August 30, 2022
First decision: December 9, 2022
Revised: January 2, 2023
Accepted: January 16, 2023
Article in press: January 16, 2023
Published online: February 6, 2023
Processing time: 159 Days and 17.1 Hours
Abstract
BACKGROUND

A rectal neuroendocrine tumor (rNET) is a malignant tumor originating from neuroendocrine cells. Currently, tumor size is the primary basis for assessing tumor risk.

CASE SUMMARY

This article reports the case of a 46-year-old male patient who underwent a colonoscopy that found a 3 mm rectal polypoid bulge. The pathological examination of a sample collected with biopsy forceps revealed a neuroendocrine tumor. Further endoscopic submucosal dissection rescue therapy was used. The presence of lymphatic vessels indicated that the tumor had infiltrated the negative resection margin. The lesion was located in the distal rectum near the anal canal. Therefore, to ensure the patient’s quality of life, follow-up observation was conducted after full communication with the patient. No tumor recurrence or distant metastasis has been found during the 13-mo follow-up after surgery.

CONCLUSION

Despite the presence of lymphatic invasion and extremely small diameter rNETs in our case, this phenomenon may not imply a higher risk of distant lymph node and organ metastasis.

Keywords: Rectal neuroendocrine tumor; Tumor size; Lymphatic invasion; Case report

Core Tip: Due to the heterogeneity and atypical symptoms of rectal neuroendocrine tumors, in the process of clinical diagnosis and treatment, it is not sufficient to judge the risk of tumor metastasis based only on tumor size and lymphovascular invasion. Therefore, during treatment, it is necessary to formulate an individualized plan, undertake close follow-up observation, and try to improve the quality of life and disease prognosis of patients while reducing the burden of treatment.