Alteration in bowel habit and mass in the right lower abdomen.
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There is a heterogeneously enhancing soft tissue mass lesion seen in the right iliac fossa, arising from the mesentery of small bowel. It contains areas of necrosis and foci of calcifications and causes a desmoplastic reaction.
Multiple adjacent ovoid-shaped enhancing regional lymph nodes are also present.
Multiple hypodense lesions seen scattered in the liver; the largest one is seen in segment IVa, concerning for metastases.
Multiple enhancing pathological lymph nodes are seen in the celiac, preaortic, aortocaval, left and right para-aortic, peripancreatic regions and the mesentery.
The diagnosis was suggested by the presence of a desmoid reaction in addition to the lab results. Histology confirms the mass as a well-differentiated neuroendocrine tumor (carcinoid tumor).