内镜下黏膜剥离术治疗直肠多发类癌1例

Endoscopic mucosal dissection for multiple rectal carcinoids: A case report

背景 直肠多发类癌,临床发病率较低,内镜下可达到治愈性切除,但有漏诊病灶的风险,术后随访非常重要.病例简介 本例患者因反复便血2月余就诊我院行肠镜检查,诊断为直肠多发类癌、痔疮等疾病,完善胸部+腹部+盆腔增强CT等检查排除类癌转移后行内镜下病变切除术治疗,共完整切除病灶8枚,术后病理+免疫组化再次证实为类癌组织,分类为G1,术后3 mo随访肠镜未见新发病灶.结论 对于小于1 cm的直肠多发类癌是可以通过内镜下剥离术治愈的,但需注意术后密切随访.

BACKGROUND Multiple rectal carcinoids have a low incidence clinically.Curative resection can be achieved by endoscopy, but there is a risk of missing the lesion. Postoperative followup is very important.CASE SUMMARY A patient was diagnosed with multiple rectal carcinoids and hemorrhoids by colonoscopy due to repeated hematochezia for more than 2 mo. After chest, abdominal and pelvic contrast-enhanced CT examinations were completed to exclude carcinoid metastasis, endoscopic lesion resection was performed. A total of eight lesions were completely removed. Postoperative pathology and immunohistochemistry confirmed carcinoids, classified as G1. No new lesions were found by colonoscopy 3 mo after operation.CONCLUSION For multiple rectal carcinoids smaller than 1 cm, endoscopic dissection can be curative, but close follow-up should be performed.