International Journal of Colorectal Disease

, Volume 34, Issue 11, pp 1887–1894 | Cite as

Clinicopathological characteristics and frequency of multiple rectal neuroendocrine tumors: a single-center retrospective study

  • Yusuke Nishikawa
  • Akiko ChinoEmail author
  • Daisuke Ide
  • Shoichi Saito
  • Masahiro Igarashi
  • Manabu Takamatsu
  • Junko Fujisaki
  • Yoshinori Igarashi
Original Article



Rectal multiple neuroendocrine tumors (M-NETs) are rare, with only few epidemiologic reports on the topic. Therefore, their clinicopathological features are not completely known, and the appropriate treatment strategy has not been established.


This study aimed to compare the clinicopathological malignant potential (lymphatic or venous invasion-positive and lymph node metastasis rates) of M-NETs with that of solitary NETs (S-NETs).


We retrospectively investigated 369 patients with NETs of the rectum. Patients who underwent colonoscopy at the Cancer Institute Hospital between January 1979 and 2016 and diagnosed with S-NETs were included, and S-NETs were found in 348 patients. Patients with M-NETs were classified into two groups as follows: patients with < 8 tumors (several (S) group, n = 21) and those with ≥ 8 tumors (numerous (N) group, n = 3).


The overall frequency of M-NETs was 5.7% and that of the N group was 0.8%. The mean tumor diameter in the N group was 6.0 mm (range, 4–8 mm). The lymphatic invasion rates of the S-NETs, and S and N groups of the M-NETs were 8.9%, 5.6%, and 66.7%, respectively. Moreover, the lymph node metastasis rates were 9.2%, 11.1%, and 33.3, respectively.


While M-NETs in the S and N groups had different characteristics, they were rarer in the N group. The N group may have higher rates of lymphatic invasion and lymph node metastasis regardless of tumor size.


Neuroendocrine tumor Multiple rectal neuroendocrine tumor Gastrointestinal neuroendocrine tumor Lymph node metastasis Epidemiology for neuroendocrine tumor 



We would like to thank the pathologists, Hiroshi Kawachi and Noriko Yamamoto, who contributed to the pathological diagnoses in this study.

Compliance with ethical standards

The study protocol was reviewed and approved by the institutional review boards of the participating institutions.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yusuke Nishikawa
    • 1
    • 2
  • Akiko Chino
    • 1
    Email author
  • Daisuke Ide
    • 1
  • Shoichi Saito
    • 1
  • Masahiro Igarashi
    • 1
  • Manabu Takamatsu
    • 3
  • Junko Fujisaki
    • 1
  • Yoshinori Igarashi
    • 2
  1. 1.Department of Gastroenterology, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
  2. 2.Departments of GastroenterologyToho University Oomori hospitalTokyoJapan
  3. 3.Division of Pathology, The Cancer InstituteJapanese Foundation for Cancer ResearchTokyoJapan

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