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Watch-an-wait strategy for multiple rectal neuroendocrine tumors with widespread invasion

Journal Volume 86 - 2023
Issue Fasc.4 - Case reports
Author(s) N. Torres 1, M. El Moussaoui 2, S. Basbous 3, V. Fridman 4, I. Borbath 5, J. Deflandre 6
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(1) Department of Gastroenterology, Cliniques universitaires St Luc, Yvoir, Belgium
(2) Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, Liège, Belgium
(3) Department of Gastroenterology, University Hospital of Charleroi, Charleroi, Belgium
(4) Department of Anatomopathology, University Hospital of Liège, Liège, Belgium
(5) Department of Gastroenterology, Cliniques universitaires St Luc, Brussels, Belgium
(6) Department of Gastroenterology, Centre Hospitalier Régional (CHR) de Liège, Liège, Belgium

A 57-year-old man with a history of surgical resection for subocclusive small bowel Crohn’s disease, was referred for endoscopic follow-up. Rectal neuroendocrine tumor(rNETs) was found during screening colonoscopy in the form of a centimetric polyp. A post-polypectomy endoscopy was reassuring while random biopsies performed showed low grade multiple rNETs diffusely infiltrating the mucosa and submucosa. Both abdominal-pelvic computed tomography (CT) and endoscopic ultrasonography echoendoscopy (EUS) did not identify any lymph node or distant lesion. Watch-and-wait strategy was performed by regular colonoscopy and EUS. As far as we know, this case is the unique case reported of non-progressive diffuse multiple rectal neuroendocrine tumors after a very long-term follow-up of 20 years. This case further supports that “Watch and wait” could be a safe alternative management strategy for selected rNETs, specially in patients for whom the surgical risk is increased with a potentially significant impact on the quality of life.

Keywords: Neuroendocrine neoplasm, staging, neuroendocrine carcinoma, endocrine cell micronests.

The authors declare that they have no conflict of interest.
© Acta Gastro-Enterologica Belgica.
PMID 38240551