Presentation
Altered bowel habits
Patient Data
Circumferential thickening of the distal ileum, extending over a length of 5cm which is compatible with the known history of carcinoid tumor (biopsy proven at endoscopy).
The appendix is unremarkable. Calcified nodule with minimally stellate appearance in the adjacent mesocolon. Further irregular circumferential thickening of the pylorus of the stomach, extending to the D1 segment of the duodenum. This extends for approximately 3 cm.
Further low attenuation lesion within the proximal small bowel, at the level of the DJ flexure measuring approximately 2.6 cm.
Solitary liver lesion within segment VIII of the liver, which is minimally enhancing and measures approximately 4.6 x 3.5 cm.
7mm low attenuation exophytic lesion inferior pole right kidney is too small to characterize on CT, but is likely a cyst.
Sliding hiatus hernia.
No significant abdominal or pelvic lymphadenopathy.
Case Discussion
A carcinoid tumor is a type of neuroendocrine tumor which can occur in number of locations.
Carcinoid tumors arise from endocrine amine precursor uptake and decarboxylation (APUD) cells that can be found throughout the gastrointestinal tract as well as other organs (e.g. lung). In general they are slow growing tumors, but are nevertheless capable of metastasis.
The gastrointestinal tract accounts for ~ 85% carcinoid tumors while carcinoid accounts for ~ 2% of gastrointestinal tract tumors.
- appendiceal carcinoid - the appendix accounts for ~ 50% of all carcinoid tumors
- small bowel carcinoid - the terminal ileum accounts for ~ 90% of all small bowel carcinoid tumors
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