Endosonography Probe-Guided Endoscopic Resection of Small Flat Rectal Carcinoid Tumor Using Band Ligation Technique

Figure 1Colonoscopy on a 42-year-old woman revealed a small rectal submucosal nodule.

Figure 2Subsequent endosonography using a 12-MHz ultrasound miniprobe (SP-701; Fujinon, Omiya, Japan) demonstrated a hypoechoic solid tumor (arrow) in the superficial submucosa (sm).

Figure 3The tumor was treated by endosonography probe-guided endoscopic resection using band ligation, by means of a gastroduodenoscope with an attached single-band ligator (Sumitomo Bakelite; Tokyo, Japan), and 5 ml of epinephrine-supplemented glycerin solution (gly) was injected underneath the lesion. Endosonography confirmed separation of the tumor from underlying muscle layer.

Figure 4The lesion was aspirated into the ligator and the band was deployed, creating a bulging polyp. A snare polypectomy was performed below the band. Histological examination confirmed that the carcinoid tumor had been completely excised.