Carcinoid tumour

Case contributed by Dr James Sheldon

Presentation

Altered bowel habits

Patient Data

Age: 70 years
Gender: Male
CT

Circumferential thickening of the distal ileum, extending over a length of 5cm which is compatible with the known history of carcinoid tumour (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 characterise on CT, but is likely a cyst.

Sliding hiatus hernia. 

No significant abdominal or pelvic lymphadenopathy.

Case Discussion

A carcinoid tumour is a type of  neuroendocrine tumour which can occur in number of locations.

Carcinoid tumours 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 tumours, but are nevertheless capable of metastasis.

The gastrointestinal tract accounts for ~ 85% carcinoid tumours while carcinoid accounts for ~ 2% of gastrointestinal tract tumours.  

  • appendiceal carcinoid - the appendix accounts for ~ 50% of all carcinoid tumours
  • small bowel carcinoid - the terminal ileum accounts for ~ 90% of all small bowel carcinoid tumours 
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Case information

rID: 26918
Case created: 14th Jan 2014
Last edited: 18th May 2017
Inclusion in quiz mode: Included

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