gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2022-21-1-107-116gnck-1679Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWУльтразвуковая визуализация субэпителиальных опухолей прямой кишки (обзор литературы)Ultrasound imaging of subepithelial rectal tumors (review)https://orcid.org/0000-0002-8403-195XТрубачеваЮ. Л.TrubachevaY. L.

123423, Москва, ул. Саляма Адиля, д. 2

123423, Moscow, Salyama Adilya str., 2

trubacheva.70@mail.ruhttps://orcid.org/0000-0001-7734-3069БогдановаЕ. М.BogdanovaE. M.

123423, Москва, ул. Саляма Адиля, д. 2

123423, Moscow, Salyama Adilya str., 2

https://orcid.org/0000-0002-4884-876XПершинаА. Е.PershinaA. E.

123423, Москва, ул. Саляма Адиля, д. 2

123423, Moscow, Salyama Adilya str., 2

ФГБУ «НМИЦ колопроктологии имени А.Н. Рыжих» Минздрава РоссииРоссияRyzhikh National Medical Research Center of ColoproctologyRussian Federation202221032022211107116Copyright © Трубачева Ю.Л., Богданова Е.М., Першина А.Е., 20222022Трубачева Ю.Л., Богданова Е.М., Першина А.Е.Trubacheva Y.L., Bogdanova E.M., Pershina A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1679

Субэпителиальные опухоли прямой кишки представляют собой группу разнородных по гистологической структуре опухолей, расположенных под эпителием слизистой оболочки стенки кишки и не имеющих специфических клинических проявлений. Их дифференциальная диагностика является актуальной проблемой, поскольку прогноз и тактика лечения зависят от конкретного типа опухоли. Целью работы было изучение возможностей ультразвукового метода в диагностике субэпителиальных опухолей прямой кишки и поиск отличительных признаков для каждого типа опухоли. Анализ литературных данных показал, что ультразвуковое исследование как составная часть комплексной диагностики с применением методов медицинской визуализации (УЗИ, КТ, МРТ) позволяет выявлять и характеризовать данные опухоли, предоставляя ценную информацию для определения дальнейшей тактики ведения пациентов.

Subepithelial rectal tumors are a group of histologically heterogeneous neoplasms located under the epithelium of the mucosa and have no specific clinical manifestations. Differential diagnosis of these tumors is an urgent problem, since the prognosis and treatment choice depend on the specific type of tumor. The aim of the work was to study the possibilities of the ultrasound method in the diagnosis of subepithelial rectal tumors and to identify signs for each type of tumor. An analysis of the literature data showed that ultrasound as an integral part of complex diagnostics using medical imaging methods (ultrasound, CT, MRI) makes it possible to identify and characterize these tumors, providing valuable information for the treatment.

субэпителиальная опухольэндоректальное ультразвуковое исследованиемагнитно-резонансная томографиякомпьютерная томографияsubepithelial tumorendorectal ultrasoundmagnetic resonance imagingcomputed tomographyReferencesStandards of Practice Committee, Faulx AL, Kothari S, et al. The role of endoscopy in subepithelial lesions of the GI tract. Gastrointest Endosc. 2017;85(6):1117–1132. DOI:10.1016/j.gie.2017.02.022Standards of Practice Committee, Faulx AL, Kothari S, et al. The role of endoscopy in subepithelial lesions of the GI tract. Gastrointest Endosc. 2017;85(6):1117–1132. DOI:10.1016/j.gie.2017.02.022Menon L, Buscaglia JM. Endoscopic approach to subepithelial lesions. Therap Adv Gastroenterol. 2014;7(3):123–130. DOI:10.1177/1756283X13513538Menon L, Buscaglia JM. Endoscopic approach to subepithelial lesions. Therap Adv Gastroenterol. 2014;7(3):123–130. DOI:10.1177/1756283X13513538Старков Ю.Г., Солодинина Е.Н., Новожилова А.В. Подслизистые новообразования желудочно-кишечного тракта в эндоскопической практике. Хирургия. Журнал им. Н.И. Пирогова. 2010;2:51–59.Starkov Yu.G., Solodinina E.N., Novozhilova A.V. Submucosal neoplasms of the gastrointestinal tract in endoscopic practice. Khirurgiya. Zhurnalim. N.I. Pirogova. 2010;2:51–9. (in Russ.).Hwang JH, Saunders MD, Rulyak SJ, Shaw S, et al. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest Endosc. 2005;62(2):202–8. DOI:10.1016/s0016-5107(05)01567-1Hwang JH, Saunders MD, Rulyak SJ, Shaw S, et al. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest Endosc. 2005;62(2):202–8. DOI:10.1016/s0016-5107(05)01567-1Eckardt AJ, Wassef W. Diagnosis of subepithelial tumors in the GI tract. Endoscopy, EUS, and histology: bronze, silver, and gold standard? Gastrointest Endosc. 2005;62(2):209–212. DOI:10.1016/j.gie.2005.05.001Eckardt AJ, Wassef W. Diagnosis of subepithelial tumors in the GI tract. Endoscopy, EUS, and histology: bronze, silver, and gold standard? Gastrointest Endosc. 2005;62(2):209–212. DOI:10.1016/j.gie.2005.05.001Hasak S, Kushnir V. Rectal Endoscopic Ultrasound in Clinical Practice. Curr Gastroenterol Rep. 2019;21(4):18. DOI:10.1007/s11894-019-0682-9Hasak S, Kushnir V. Rectal Endoscopic Ultrasound in Clinical Practice. Curr Gastroenterol Rep. 2019;21(4):18. DOI:10.1007/s11894-019-0682-9Cârțână ET, Gheonea DI, Săftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol. 2016;22(5):1756–1766. DOI:10.3748/wjg.v22.i5.1756Cârțână ET, Gheonea DI, Săftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol. 2016;22(5):1756–1766. DOI:10.3748/wjg.v22.i5.1756Tamura T, Kitano M. Contrast Enhanced Endoscopic Ultrasound Imaging for Gastrointestinal Subepithelial Tumors. Clin Endosc. 2019;52(4):306–313. DOI:10.5946/ce.2019.056Tamura T, Kitano M. Contrast Enhanced Endoscopic Ultrasound Imaging for Gastrointestinal Subepithelial Tumors. Clin Endosc. 2019;52(4):306–313. DOI:10.5946/ce.2019.056Kim SH, Yoo IK, Kwon CI et al. Utility of EUS elastography in the diagnosis of gastric subepithelial tumors: a pilot study (with video). Gastrointest Endosc. 2020;91(1):172–177.e2. DOI:10.1016/j.gie.2019.09.012Kim SH, Yoo IK, Kwon CI et al. Utility of EUS elastography in the diagnosis of gastric subepithelial tumors: a pilot study (with video). Gastrointest Endosc. 2020;91(1):172–177.e2. DOI:10.1016/j.gie.2019.09.012Kucharzik T, Maaser C. Contrast-enhanced harmonic endoscopic ultrasound is able to discriminate benign submucosal lesions from gastrointestinal stromal tumors. Scand J Gastroenterol. 2012;47(12):1515–1520. DOI:10.3109/00365521.2012.729082Kucharzik T, Maaser C. Contrast-enhanced harmonic endoscopic ultrasound is able to discriminate benign submucosal lesions from gastrointestinal stromal tumors. Scand J Gastroenterol. 2012;47(12):1515–1520. DOI:10.3109/00365521.2012.729082Sakamoto H, Kitano M, Matsui S, Kamata K, et al. Estimation of malignant potential of GI stromal tumors by contrast-enhanced harmonic EUS (with videos). Gastrointest Endosc. 2011;73(2):227–237. DOI:10.1016/j.gie.2010.10.011Sakamoto H, Kitano M, Matsui S, Kamata K, et al. Estimation of malignant potential of GI stromal tumors by contrast-enhanced harmonic EUS (with videos). Gastrointest Endosc. 2011;73(2):227–237. DOI:10.1016/j.gie.2010.10.011Yamashita Y, Kato J, Ueda K, Nakamura Y, et al. Contrastenhanced endoscopic ultrasonography can predict a higher malignant potential of gastrointestinal stromal tumors by visualizing large newly formed vessels. J Clin Ultrasound. 2015;43(2):89–97. DOI:10.1002/jcu.22195Yamashita Y, Kato J, Ueda K, Nakamura Y, et al. Contrastenhanced endoscopic ultrasonography can predict a higher malignant potential of gastrointestinal stromal tumors by visualizing large newly formed vessels. J Clin Ultrasound. 2015;43(2):89–97. DOI:10.1002/jcu.22195Cazacu IM, Singh BS, Luzuriaga Chavez AA, et al. EUS and EUSguided FNA/core biopsies in the evaluation of subepithelial lesions of the lower gastrointestinal tract: 10-year experience. Endosc Ultrasound. 2020;9(5):329–336. DOI:10.4103/eus.eus_51_20Cazacu IM, Singh BS, Luzuriaga Chavez AA, et al. EUS and EUSguided FNA/core biopsies in the evaluation of subepithelial lesions of the lower gastrointestinal tract: 10-year experience. Endosc Ultrasound. 2020;9(5):329–336. DOI:10.4103/eus.eus_51_20Zhang Q, Zhao JY, Zhuang H et al. Transperineal core-needle biopsy of a rectal subepithelial lesion guided by endorectal ultrasound after contrast-enhanced ultrasound: A case report. World J Gastroenterol. 2021;27(13):1354–1361. DOI:10.3748/wjg.v27.i13.1354Zhang Q, Zhao JY, Zhuang H et al. Transperineal core-needle biopsy of a rectal subepithelial lesion guided by endorectal ultrasound after contrast-enhanced ultrasound: A case report. World J Gastroenterol. 2021;27(13):1354–1361. DOI:10.3748/wjg.v27.i13.1354Burdan F, Sudol-Szopinska I, Staroslawska E et al. Magnetic resonance imaging and endorectal ultrasound for diagnosis of rectal lesions. Eur J Med Res. 2015;20(1):4. DOI:10.1186/s40001-014-0078-0Burdan F, Sudol-Szopinska I, Staroslawska E et al. Magnetic resonance imaging and endorectal ultrasound for diagnosis of rectal lesions. Eur J Med Res. 2015;20(1):4. DOI:10.1186/s40001-014-0078-0Kim H, Kim JH, Lim JS et al. MRI findings of rectal submucosal tumors. Korean J Radiol. 2011;12(4):487–498. DOI:10.3348/kjr.2011.12.4.487Kim H, Kim JH, Lim JS et al. MRI findings of rectal submucosal tumors. Korean J Radiol. 2011;12(4):487–498. DOI:10.3348/kjr.2011.12.4.487Lee NK, Kim S, Kim GH et al. Hypervascular subepithelial gastrointestinal masses: CT-pathologic correlation. Radiographics. 2010;30(7):1915–1934. DOI:10.1148/rg.307105028Lee NK, Kim S, Kim GH et al. Hypervascular subepithelial gastrointestinal masses: CT-pathologic correlation. Radiographics. 2010;30(7):1915–1934. DOI:10.1148/rg.307105028Международная классификация болезней — онкология (МКБО), 3 издание, 1 пересмотр/сост. Фритц Э., Перси К., Джек Э., Шанмугаратнам К. и соавт. (пер. с англ. А.В. Филочкиной, под ред. А.М. Беляева, О.Ф. Чепика, А.С. Артемьевой, А.А. Барчука, Ю.И. Комарова). Санкт-Петербург. Вопросы онкологии. 2017; 352 с.International Classification of Diseases — Oncology (ICD-O), 3rd edition, 1st revision / A. Fritz, C. Percy, A. Jack, K. Shanmugaratnam et al., trans. from English A.V. Filochkina, ed. A.M. Belyaeva, O.F. Chepika, A.S. Artemyeva, A.A. Barchuk, Yu.I. Komarov. (St.-Petersburg). Voprosy Onkologii. 2017; 352 p. (in Russ.).Клинические рекомендации «Гастроинтестинальные стромальные опухоли» (утв. Минздравом России) [Электронный ресурс]. 2020. Режим доступа: https://cr.minzdrav.gov.ru/recomend/551_1.Clinical guidelines “Gastrointestinal stromal tumors” (approved by the Ministry of Health of Russia) [Electronic resource]. 2020. Access mode: https://cr.minzdrav.gov.ru/recomend/551_1. (in Russ.).Rubin BP, Heinrich MC, Corless CL. Gastrointestinal stromal tumour [published correction appears in Lancet. 2007 Aug 4;370(9585):388]. Lancet. 2007;369(9574):1731–1741. DOI:10.1016/S0140-6736(07)60780-6Rubin BP, Heinrich MC, Corless CL. Gastrointestinal stromal tumour [published correction appears in Lancet. 2007 Aug 4;370(9585):388]. Lancet. 2007;369(9574):1731–1741. DOI:10.1016/S0140-6736(07)60780-6Kukar M, Kapil A, Papenfuss W et al. Gastrointestinal stromal tumors (GISTs) at uncommon locations: a large population based analysis. J Surg Oncol. 2015;111(6):696–701. DOI:10.1002/jso.23873Kukar M, Kapil A, Papenfuss W et al. Gastrointestinal stromal tumors (GISTs) at uncommon locations: a large population based analysis. J Surg Oncol. 2015;111(6):696–701. DOI:10.1002/jso.23873Ma GL, Murphy JD, Martinez ME et al. Epidemiology of gastrointestinal stromal tumors in the era of histology codes: results of a population-based study. Cancer Epidemiol Biomarkers Prev. 2015;24(1):298–302. DOI:10.1158/1055-9965.EPI-14-1002Ma GL, Murphy JD, Martinez ME et al. Epidemiology of gastrointestinal stromal tumors in the era of histology codes: results of a population-based study. Cancer Epidemiol Biomarkers Prev. 2015;24(1):298–302. DOI:10.1158/1055-9965.EPI-14-1002Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23(2):70–83. DOI:10.1053/j.semdp.2006.09.001Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23(2):70–83. DOI:10.1053/j.semdp.2006.09.001Søreide K, Sandvik OM, Søreide JA et al. Global epidemiology of gastrointestinal stromal tumours (GIST): A systematic review of population-based cohort studies. Cancer Epidemiol. 2016;40:39–46. DOI:10.1016/j.canep.2015.10.031Søreide K, Sandvik OM, Søreide JA et al. Global epidemiology of gastrointestinal stromal tumours (GIST): A systematic review of population-based cohort studies. Cancer Epidemiol. 2016;40:39–46. DOI:10.1016/j.canep.2015.10.031Tran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. Am J Gastroenterol. 2005;100(1):162–168. DOI:10.1111/j.1572-0241.2005.40709.xTran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. Am J Gastroenterol. 2005;100(1):162–168. DOI:10.1111/j.1572-0241.2005.40709.xBaik S, Kim N, Lee C et al. Gastrointestinal stromal tumor of the rectum: an analysis of seven cases. Surg Today. 2007;37(6):455–459. DOI:10.1007/s00595-006-3424-1Baik S, Kim N, Lee C et al. Gastrointestinal stromal tumor of the rectum: an analysis of seven cases. Surg Today. 2007;37(6):455–459. DOI:10.1007/s00595-006-3424-1Kameyama H, Kanda T, Tajima Y et al. Management of rectal gastrointestinal stromal tumor. Transl Gastroenterol Hepatol. 2018;3:8. DOI:10.21037/tgh.2018.01.08Kameyama H, Kanda T, Tajima Y et al. Management of rectal gastrointestinal stromal tumor. Transl Gastroenterol Hepatol. 2018;3:8. DOI:10.21037/tgh.2018.01.08Boehm G, Mang T, Gschwendtner M. Rektaler GIST als Zufallsbefund in der CT-Kolonografie [Rectal GIST as an incidental finding on CT colonography]. Rofo. 2013;185(11):1095–1097. DOI:10.1055/s0033-1335682Boehm G, Mang T, Gschwendtner M. Rektaler GIST als Zufallsbefund in der CT-Kolonografie [Rectal GIST as an incidental finding on CT colonography]. Rofo. 2013;185(11):1095–1097. DOI:10.1055/s0033-1335682Kane WJ, Friel CM. Diagnosis and Treatment of Rectal Gastrointestinal Stromal Tumors. Dis Colon Rectum. 2019;62(5):537–540. DOI:10.1097/DCR.0000000000001376Kane WJ, Friel CM. Diagnosis and Treatment of Rectal Gastrointestinal Stromal Tumors. Dis Colon Rectum. 2019;62(5):537–540. DOI:10.1097/DCR.0000000000001376Zhou Y, Wu XD, Fan RG et al. Rectal gastrointestinal stromal tumor as an incidental finding in a patient with rectal polyps. Int J Clin Exp Pathol. 2015;8(5):5934–5937.Zhou Y, Wu XD, Fan RG et al. Rectal gastrointestinal stromal tumor as an incidental finding in a patient with rectal polyps. Int J Clin Exp Pathol. 2015;8(5):5934–5937.Digestive System Tumors. WHO Classification of Tumors, 5th Edition, Volume 1. 2019.Digestive System Tumors. WHO Classification of Tumors, 5th Edition, Volume 1. 2019.Brunaldi VO, Coronel M, Chacon DA et al. Subepithelial rectal gastrointestinal stromal tumor — the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report. J Med Case Rep. 2017;11(1):59. DOI:10.1186/s13256-017-1205-7Brunaldi VO, Coronel M, Chacon DA et al. Subepithelial rectal gastrointestinal stromal tumor — the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report. J Med Case Rep. 2017;11(1):59. DOI:10.1186/s13256-017-1205-7Purysko AS, Coppa CP, Kalady MF et al. Benign and malignant tumors of the rectum and perirectal region. Abdom Imaging. 2014;39(4):824–852. DOI:10.1007/s00261-014-0119-8Purysko AS, Coppa CP, Kalady MF et al. Benign and malignant tumors of the rectum and perirectal region. Abdom Imaging. 2014;39(4):824–852. DOI:10.1007/s00261-014-0119-8Hamada Y, Tanaka K, Hattori A, Takei Y. An Unusual Case of Rectal Submucosal Tumor. Intern Med. 2020;59(6):865–866. DOI:10.2169/internalmedicine.4040-19Hamada Y, Tanaka K, Hattori A, Takei Y. An Unusual Case of Rectal Submucosal Tumor. Intern Med. 2020;59(6):865–866. DOI:10.2169/internalmedicine.4040-19Okai T, Minamoto T, Ohtsubo K et al. Endosonographic evaluation of c-kit-positive gastrointestinal stromal tumor. Abdom Imaging. 2003;28(3):301–307. DOI:10.1007/s00261-002-0055-xOkai T, Minamoto T, Ohtsubo K et al. Endosonographic evaluation of c-kit-positive gastrointestinal stromal tumor. Abdom Imaging. 2003;28(3):301–307. DOI:10.1007/s00261-002-0055-xKannengiesser K, Mahlke R, Petersen F, Peters A, et al. Contrastenhanced harmonic endoscopic ultrasound is able to discriminate benign submucosal lesions from gastrointestinal stromal tumors. Scand J Gastroenterol. 2012;47(12), 1515–1520. DOI:10.3109/00365521.2012.729082Kannengiesser K, Mahlke R, Petersen F, Peters A, et al. Contrastenhanced harmonic endoscopic ultrasound is able to discriminate benign submucosal lesions from gastrointestinal stromal tumors. Scand J Gastroenterol. 2012;47(12), 1515–1520. DOI:10.3109/00365521.2012.729082Thompson WM. Imaging and findings of lipomas of the gastrointestinal tract. AJR Am J Roentgenol. 2005;184(4):1163–1171. DOI:10.2214/ajr.184.4.01841163Thompson WM. Imaging and findings of lipomas of the gastrointestinal tract. AJR Am J Roentgenol. 2005;184(4):1163–1171. DOI:10.2214/ajr.184.4.01841163Dagmura H, Daldal E, Akbaş A, Daşıran F. A rare anal mass: anal leiomyoma presented as perianal fistula. J Surg Case Rep. 2019;2019(2):rjy351. DOI:10.1093/jscr/rjy351Dagmura H, Daldal E, Akbaş A, Daşıran F. A rare anal mass: anal leiomyoma presented as perianal fistula. J Surg Case Rep. 2019;2019(2):rjy351. DOI:10.1093/jscr/rjy351Sturiale A, Fabiani B, Naldini G. A rare case of leiomyoma of the internal anal sphincter. Int J Surg Case Rep. 2016;23:4–7. DOI:10.1016/j.ijscr.2016.03.048Sturiale A, Fabiani B, Naldini G. A rare case of leiomyoma of the internal anal sphincter. Int J Surg Case Rep. 2016;23:4–7. DOI:10.1016/j.ijscr.2016.03.048Sunkara T, Then EO, Culliford A, Gaduputi V. Rectal leiomyoma, a rare entity. Clin Pract. 2018;8(2):1053. DOI:10.4081/cp.2018.1053Sunkara T, Then EO, Culliford A, Gaduputi V. Rectal leiomyoma, a rare entity. Clin Pract. 2018;8(2):1053. DOI:10.4081/cp.2018.1053De Palma GD, Rega M, Masone S, et al. Lower gastrointestinal bleeding secondary to a rectal leiomyoma. World J Gastroenterol. 2009;15(14):1769–1770. DOI:10.3748/wjg.15.1769De Palma GD, Rega M, Masone S, et al. Lower gastrointestinal bleeding secondary to a rectal leiomyoma. World J Gastroenterol. 2009;15(14):1769–1770. DOI:10.3748/wjg.15.1769García-Santos EP, Ruescas-García FJ, Estaire-Gómez M, et al. Leiomioma anorrectal. Presentación de un caso y revisión de la literatura [Anorectal leiomyoma: a case report and literature review]. Rev Gastroenterol Mex. 2014;79(1):58–60. DOI:10.1016/j.rgmx.2013.05.002García-Santos EP, Ruescas-García FJ, Estaire-Gómez M, et al. Leiomioma anorrectal. Presentación de un caso y revisión de la literatura [Anorectal leiomyoma: a case report and literature review]. Rev Gastroenterol Mex. 2014;79(1):58–60. DOI:10.1016/j.rgmx.2013.05.002Saunders RN, Pattenden C, Agarawal PK. Heavy rectal bleeding secondary to the passage of a rectal leiomyoma per anus. Ann R Coll Surg Engl. 2004;86(6):44–46. DOI:10.1308/147870804100Saunders RN, Pattenden C, Agarawal PK. Heavy rectal bleeding secondary to the passage of a rectal leiomyoma per anus. Ann R Coll Surg Engl. 2004;86(6):44–46. DOI:10.1308/147870804100Майновская О.А., Тарасов М.А., Романова Е.М., Чернышов С.В. Мезенхимальные опухоли толстой кишки: диагностика, лечение, прогноз (клинический случай и обзор литературы). Колопроктология. 2020;19(3):97–112. DOI:10.33878/2073-7556-2020-19-3-97-112Mainovskaya O.A., Tarasov M.A., Romanova E.M., Chernyshov S.V. Mesenchymal tumors of the colon and rectum: diagnosis, treatment, prognosis (case report and review). Koloproktologia. 2020;19(3):97–112. (in Russ.). DOI:10.33878/2073-7556-2020-19-3-97-112Rouse HC, Godoy MC, Lee WK, et al. Imaging findings of unusual anorectal and perirectal pathology: a multi-modality approach. Clin Radiol. 2008;63(12):1350–1360. DOI:10.1016/j.crad.2008.06.008Rouse HC, Godoy MC, Lee WK, et al. Imaging findings of unusual anorectal and perirectal pathology: a multi-modality approach. Clin Radiol. 2008;63(12):1350–1360. DOI:10.1016/j.crad.2008.06.008Hsieh JS, Huang CJ, Wang JY, Huang TJ. Benefits of endorectal ultrasound for management of smooth-muscle tumor of the rectum: report of three cases. Dis Colon Rectum. 1999;42(8):1085–1088. DOI:10.1007/BF02236709Hsieh JS, Huang CJ, Wang JY, Huang TJ. Benefits of endorectal ultrasound for management of smooth-muscle tumor of the rectum: report of three cases. Dis Colon Rectum. 1999;42(8):1085–1088. DOI:10.1007/BF02236709Khalifa AA, Bong WL, Rao VK, Williams MJ. Leiomyosarcoma of the rectum. Report of a case and review of the literature. Dis Colon Rectum. 1986;29(6):427–432. DOI:10.1007/BF02555068Khalifa AA, Bong WL, Rao VK, Williams MJ. Leiomyosarcoma of the rectum. Report of a case and review of the literature. Dis Colon Rectum. 1986;29(6):427–432. DOI:10.1007/BF02555068Kurugoglu S, Ogut G, Mihmanli I et al. Abdominal leiomyosarcomas: radiologic appearances at various locations. Eur Radiol. 2002;12(12):2933–2942. DOI:10.1007/s00330-002-1358-6Kurugoglu S, Ogut G, Mihmanli I et al. Abdominal leiomyosarcomas: radiologic appearances at various locations. Eur Radiol. 2002;12(12):2933–2942. DOI:10.1007/s00330-002-1358-6Zbar AP, Sokolowsky N, Sandiford N, Prussia PR. Leiomyosarcoma of the rectum: a report of two cases and review of the literature. West Indian Med J. 2004;53(2):122–125.Zbar AP, Sokolowsky N, Sandiford N, Prussia PR. Leiomyosarcoma of the rectum: a report of two cases and review of the literature. West Indian Med J. 2004;53(2):122–125.Modlin IM, Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer. 1997;79(4):813–829. DOI:10.1002/(sici)1097-0142(19970215)79:4<813::aid-cncr19>3.0.co;2-2Modlin IM, Sandor A. An analysis of 8305 cases of carcinoid tumors. Cancer. 1997;79(4):813–829. DOI:10.1002/(sici)1097-0142(19970215)79:4<813::aid-cncr19>3.0.co;2-2Ahmed M. Gastrointestinal neuroendocrine tumors in 2020. World J Gastrointest Oncol. 2020;12(8):791–807. DOI:10.4251/wjgo.v12.i8.791Ahmed M. Gastrointestinal neuroendocrine tumors in 2020. World J Gastrointest Oncol. 2020;12(8):791–807. DOI:10.4251/wjgo.v12.i8.791Gu Q, Lin YM, Cen L, et al. Endoscopic ultrasonography is useful in the diagnosis and treatment of rectal neuroendocrine neoplasms: a case series. J Zhejiang Univ Sci B. 2019;20(10):861–864. DOI:10.1631/jzus.B1900168Gu Q, Lin YM, Cen L, et al. Endoscopic ultrasonography is useful in the diagnosis and treatment of rectal neuroendocrine neoplasms: a case series. J Zhejiang Univ Sci B. 2019;20(10):861–864. DOI:10.1631/jzus.B1900168Basuroy R, Haji A, Ramage JK, Quaglia A, et al. Review article: the investigation and management of rectal neuroendocrine tumours. Aliment Pharmacol Ther. 2016;44(4):332–345. DOI:10.1111/apt.13697Basuroy R, Haji A, Ramage JK, Quaglia A, et al. Review article: the investigation and management of rectal neuroendocrine tumours. Aliment Pharmacol Ther. 2016;44(4):332–345. DOI:10.1111/apt.13697Yuen B, Hung B, Cho C, et al. Magnetic resonance imaging for rectal submucosal tumours. Hong Kong J Radiol. 2017;20:272–281. DOI:10.12809/hkjr1716935Yuen B, Hung B, Cho C, et al. Magnetic resonance imaging for rectal submucosal tumours. Hong Kong J Radiol. 2017;20:272–281. DOI:10.12809/hkjr1716935Park CH, Cheon JH, Kim JO, Shin JE, et al. Criteria for decision making after endoscopic resection of well-differentiated rectal carcinoids with regard to potential lymphatic spread. Endoscopy. 2011;43(9):790–795. DOI:10.1055/s-0030-1256414Park CH, Cheon JH, Kim JO, Shin JE, et al. Criteria for decision making after endoscopic resection of well-differentiated rectal carcinoids with regard to potential lymphatic spread. Endoscopy. 2011;43(9):790–795. DOI:10.1055/s-0030-1256414Ishii N, Horiki N, Itoh T, Maruyama M, et al. Endoscopic submucosal dissection and preoperative assessment with endoscopic ultrasonography for the treatment of rectal carcinoid tumors. Surg Endosc. 2010;24(6):1413–1419. DOI:10.1007/s00464-009-0791-xIshii N, Horiki N, Itoh T, Maruyama M, et al. Endoscopic submucosal dissection and preoperative assessment with endoscopic ultrasonography for the treatment of rectal carcinoid tumors. Surg Endosc. 2010;24(6):1413–1419. DOI:10.1007/s00464-009-0791-xChen HT, Xu GQ, Teng XD, Chen YP, et al. Diagnostic accuracy of endoscopic ultrasonography for rectal neuroendocrine neoplasms. World J Gastroenterol. 2014;20(30):10470–7. DOI:10.3748/wjg.v20.i30.10470Chen HT, Xu GQ, Teng XD, Chen YP, et al. Diagnostic accuracy of endoscopic ultrasonography for rectal neuroendocrine neoplasms. World J Gastroenterol. 2014;20(30):10470–7. DOI:10.3748/wjg.v20.i30.10470.

The authors declare that there are no conflicts of interest present.