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Presented by Ralph Hruban, M.D. and prepared by Maryam Farinola M.D.
Case 3: This 40 some year old patient was found to have a 1.5 cm rectal mass.
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1. Question
Week 178: Case 3
This 40 some year old patient was found to have a 1.5 cm rectal mass./images/carcinoid rectum 1.jpg
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/images/carcinoid rectum 4.jpgCorrect
Answer: Benign carcinoid tumor
Histology: This neoplasm is composed of cords of uniform cells. The cells have central round nuclei and a salt and pepper chromatin pattern.
Discussion: This neoplasm has the classic appearance of a carcinoid tumor. The important thing to remember about carcinoid tumors of the rectum, as is true elsewhere, is that size is the best predictor of behavior. Carcinoid tumors of the rectum that measure less than 2 cm, as is this case, are virtually all benign. In a series of 100 patients with carcinoid tumors < 2 cm, only one case, a 1.5 cm ulcerated tumor, developed metastases. Reference(s): Fitzgerald SD et al. Carcinoid tumor of the rectum. DNA ploidy is not a prognostic factor. Dis Colon Rectum. 39:643-8; 1996.
Incorrect
Answer: Benign carcinoid tumor
Histology: This neoplasm is composed of cords of uniform cells. The cells have central round nuclei and a salt and pepper chromatin pattern.
Discussion: This neoplasm has the classic appearance of a carcinoid tumor. The important thing to remember about carcinoid tumors of the rectum, as is true elsewhere, is that size is the best predictor of behavior. Carcinoid tumors of the rectum that measure less than 2 cm, as is this case, are virtually all benign. In a series of 100 patients with carcinoid tumors < 2 cm, only one case, a 1.5 cm ulcerated tumor, developed metastases. Reference(s): Fitzgerald SD et al. Carcinoid tumor of the rectum. DNA ploidy is not a prognostic factor. Dis Colon Rectum. 39:643-8; 1996.
