ALTHOUGH carcinoid tumors of the rectum are uncommon lesions, they have been reported with increasing frequency. In spite of the sizable number of reviews and case reports, there is still uncertainty, however, as to their malignant potential, and thus difficulty in determining the proper treatment. The first rectal carcinoid was described by Saltykow1 in 1912 and the initial report in the American literature was by Brunschwig2 in 1933. In 1964, Sanders and Axtell3 were able to find 311 cases, and it is obvious that many more are unreported.4 Since the original work by Gossett and Masson,5 it has been generally agreed that carcinoid tumors arise from the Kulchitsky or argentaffin cell, although Stout6 recognized certain differences between rectal and other carcinoids. The carcinoid syndrome associated with metastatic carcinoid tumors was first recognized in 1952,7 but not a single case of the syndrome has