Management of neuroendocrine tumors of the rectum

Rectal neuroendocrine tumors (NETs) have increased in prevalence due to increased detection via endoscopic screening for colorectal neoplasia, advances and availability of imaging tools along with the indolent nature of the tumor. Imaging techniques to identify rectal NETs include computed tomography, magnetic resonance imaging, and endoscopic rectal ultrasound. Rectal NETs are typically categorized by tumor size to determine if they should undergo endoscopic resection, local excision or transanal excision, or a radical resection, as per National Comprehensive Cancer Network guidelines. However, while examining the literature, multiple studies have examined outcomes for patients who did not adhere to these guidelines and had similar recurrence rates and survival as those patients who did. Therefore, we propose less aggressive treatment for rectal NETs in the absence of adverse features.