Neuroendocrine tumors of the colon and rectum

Neuroendocrine tumors of the colon and rectum are also called hindgut carcinoids. They are slow growing and usually become symptomatic late in the course of the disease. Current incidence is about one per 100,000. Tumors are graded into three levels based on tumor cell proliferation. Appendiceal carcinoids are usually found incidentally on pathology following an appendectomy. Colonic NETs present late, as large tumors, often with extensive metastatic disease when the diagnosis is made. Rectal NETs can be found incidentally when patients are undergoing a colonoscopy but can present with hematochezia or anorectal symptoms like tenesmus. Tumors with locoregional involvement have the best outcomes with resection whenever possible. Optimal management requires a multidisciplinary approach and systemic therapy is limited.