Is Rectal Tumor Serious?

Whether a rectal tumor is serious depends on the specific circumstances. Common benign tumors include polyps, lipomas, melanotic tumors, leiomyomas, and fibromas. These are generally non-cancerous conditions. While certain types of polyps, such as villous or tubulovillous adenomas, do carry a risk of malignancy, their cancerous potential is relatively low when smaller than 3 cm. These can often be removed during a colonoscopy using endoscopic techniques, minimizing the need for more invasive procedures.

When Surgery May Be Necessary

However, if the patient has a broad-based polyp with a wide base and ultrasound endoscopy reveals deep infiltration—such as beyond the mucosal layer—laparoscopic surgery may be recommended. On the other hand, lipomas typically do not require treatment, as they rarely become cancerous and often cause no symptoms. In such cases, observation without intervention may be appropriate.

More Serious Types of Rectal Tumors

Among rectal tumors, rectal cancer, neuroendocrine tumors, and malignant melanomas are considered more dangerous. While neuroendocrine tumors classified as Grade 1 (G1) or Grade 2 (G2) tend to be less aggressive, rectal neuroendocrine carcinoma is more severe and requires prompt attention. The treatment approach for colorectal cancer must be tailored based on the depth and extent of invasion, as well as whether there is distant metastasis.

Early-Stage Treatment Options

If the tumor is confined to the mucosa or the upper third of the submucosa, endoscopic submucosal dissection (ESD) may be a suitable option. This minimally invasive procedure helps preserve rectal function and reduces physical trauma to the patient, offering a faster recovery time and fewer complications.

Advanced Cases and Metastatic Disease

When distant metastasis is present, the treatment strategy depends on whether complications such as bleeding, perforation, or bowel obstruction are occurring. In the absence of these urgent issues, patients should consult with medical oncologists for a personalized evaluation. Targeted therapy may be used if specific biomarkers are present, while chemotherapy remains a standard option in the absence of targetable mutations.

The Role of Immunotherapy

With the rise of immunotherapy, biomarker testing for microsatellite instability-high (MSI-H) and mismatch repair deficiency (dMMR) has become increasingly important. Patients who test positive may benefit from immune checkpoint inhibitors, which have shown promising results in extending survival. A multidisciplinary approach—combining surgery, endoscopy, medical oncology, and immunotherapy—is essential to maximize patient outcomes and improve quality of life.