A 60−year−old man was referred to our hospital because of a positive fecal occult blood test. Colonoscopy revealed a hemi− spheric submucosal tumor, 8 mm in di− ameter, at the lower rectum (l " Fig. 1a) . There was neither a central depression nor ulceration on the lesion. The patho− logical diagnosis of the biopsy specimen was carcinoid tumor. Abdominal CT de− tected no liver or lymph node metastasis. The lesion was diagnosed as a rectal carci− noid tumor confined to the submucosal layer, and

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... herefore endoscopic submuco− sal resection with a ligating device (ESMR−L) [1] was performed.