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Abstract

Rectal neuroendocrine tumors (NETs) are increasingly identified at endoscopy the cause of which may be in part related to bowel cancer screening programs. This lecture will aid clinicians in the diagnosis and management of rectal NETs plus cutting edge advances in treatment. Whilst most rectal NETs are <1 cm there are specific endoscopic characteristics to help diagnose these tumors and also determine optimal management. These include size, atypical appearance, grade and depth of invasion. The primary resection modality influences complete resection rates and the need for secondary therapy. A thorough pre-resection diagnostic work up is required for lesions that are at higher risk of invasion and metastasis. Device-assisted endoscopic mucosal resection (EMR) and endoscopic sub-mucosal dissection (ESD) are used to resect localized rectal NETs <2 cm. The treatment of advanced disease is multi-modal.

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