Of 23 patients with carcinomas less than two centimeters in diameter located in the rectum and distal sigmoid colon, evidence of invasion was present in seven. Resections were performed for six patients, with two eventually dying from the carcinoma. Individualized management should consider the presence or absence of invasive carcinoma, appropriate resection for invasive carcinoma, biopsy of the base of the lesion if feasible when observation is planned, repeated sigmoidoscopic examinations for noninvasive carcinoma, and later resection if recurrence with invasion develops. Although approximately half of the carcinomas were associated with villous tumors, this factor was not significant in the ultimate course. The level of the lesion is important relative to the safety of total excision and rebiopsy and the type of resection to be performed.
Block, M. A.
"The Management of Small Carcinomas of the Rectum and Distal Sigmoid Colon,"
Henry Ford Hospital Medical Journal
: Vol. 22
Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol22/iss3/13