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KMID : 0988920150130020175
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Intestinal Research
2015 Volume.13 No. 2 p.175 ~ p.179
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Natural Course of an Untreated Metastatic Perirectal Lymph Node After the Endoscopic Resection of a Rectal Neuroendocrine Tumor
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Kim Sang-Hyung
Yang Dong-Hoon
Lee Jung-Su
Park So-Young
Lee Ho-Su
Lee Hyo-Jeong
Park Sang-Hyoung
Kim Kyung-Jo
Ye Byong-Duk
Byeon Jeong-Sik
Myung Seung-Jae
Yang Suk-Kyun
Kim Jin-Ho
Kim Chan-Wook
Kim Ji-Hun
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Abstract
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Lymph node metastasis is rare in small (i.e., <10 mm) rectal neuroendocrine tumors (NETs). In addition to tumor size, pathological features such as the mitotic or Ki-67 proliferation index are associated with lymph node metastasis in rectal NETs. We recently treated a patient who underwent endoscopic treatment of a small, grade 1 rectal NET that recurred in the form of perirectal lymph node metastasis 7 years later. A 7-mm-sized perirectal lymph node was noted at the time of the initial endoscopic treatment. The same lymph node was found to be slightly enlarged on follow-up and finally confirmed as a metastatic NET. Therefore, the perirectal lymph node metastasis might have been present at the time of the initial diagnosis. However, the growth rate of the lymph node was extremely low, and it took 7 years to increase in size from 7 to 10 mm. NETs with low Ki-67 proliferation index and without mitotic activity may grow extremely slowly even if they are metastatic. (Intest Res 2015;13:175-179)
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KEYWORD
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Rectum, Neuroendocrine tumor, Lymph node, Metastasis
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