Uncommon Colorectal Neoplasms

This issue of Clinics in Colon and Rectal Surgery focuses on the “most common of the uncommon” tumors affecting the colon and rectum. Many of these tumors are rare and challenging, with limited evidence for surgical and nonsurgical treatments. Several of these entities are commonly noted, but their management may be oversimplified by treating physicians.

The complex embryology, physiology, anatomy of the human pelvis makes assessment, planning, and treatment of tumors all the more important. The focus on optimum functional quality of life, control of malignancy, and palliation of symptoms when needed must all be forefront in the mind of the treating physician.

Some of these disease processes have been the subject of intense research, management evolution, and even attempts at prevention (HPV vaccine), so the future may be quite different from the past when Clinics in Colon and Rectal Surgery next reviews these subjects.

The evaluation, treatment—both surgical and pharmacologic—and the surveillance of carcinoids and neuroendocrine tumors is reviewed and discussed by Dr. John Eggenberger.

Dr. Melissa Times discusses the evaluation and surgical treatment of colorectal lymphomas. These tumors are often discussed with our colleagues in General Surgery and Oncology as collaborative care is frequently required.

Epidermoid cancers of the anal canal are presented by Drs. Shawn Webb and Chong Lee. Developments in the management, adjuvant therapy, and current staging are highlighted and discussed.

Retrorectal tumors are reviewed by Dr. Jeffrey Neale. Frequently diagnosed late and often misdiagnosed, patients with these tumors require complex care and well-reasoned approaches to optimize their recovery.

Dr. Dimitra Theodoropoulos discusses the recent evolution of therapy for colon and rectal gastrointestinal stromal tumors. Advances in chemotherapy combined with surgery have led to improvements in outcome not seen with prior treatment regimens.

Anal canal melanoma is uncommon, frequently delayed in diagnosis, and potentially morbid to treat. Dr. Amalia Stefanou and Dr. Surya Nalamati discuss the recent data and literature to help guide treatment.

Dr. Juan Lucas Poggio carefully analyzes the recent literature on premalignant lesions and squamous cell carcinoma of the anal canal. Commonly diagnosed, management requires contemporary thinking and excellent surgical technique.

Finally, Dr. Stephen Yoo summarizes the management of hemangiomas of the colon and rectum. While uncommon, hemangiomas are often prone to symptoms which require complex surgical treatment to manage; they are a challenge to the treating physician and surgeon.

It was my pleasure to review these topics, and I want to thank the contributing authors for their diligent preparation of these articles for your information, education, and enjoyment.