Carcinoid tumour wih mesenteric and hepatic metastases

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Five months history of abdominal pain, fatigue and weight loss. The ultrasound exam revealed numerous hepatic nodules. An MRI exam was requested for characterisation.

Patient Data

Age: 55 years
Gender: Male
This study is a stack
Axial T1
GE IPOP
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Coronal
FIESTA
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Axial T1
fat sat
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Axial T1
C+ fat sat
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Axial T1
C+ fat sat
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Axial
T2
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Axial
DWI
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Axial
ADC
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Coronal T1
C+ fat sat
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Info

Heterogeneously enhancing soft tissue mass within the small bowel mesentery in the mid-abdomen encasing branches of the SMA with a “spoke-like” appearance of mesenteric vessels and mild distortion of the adjacent small bowel loops. A small enhancing nodule of the adjacent bowel loop is noted (best seen on the delayed arterial phase).

Multiple hypervascular hepatic nodules of various sizes with restricted diffusion, the largest is located in the left lobe.

A small simple hepatic cyst is noted in segment VI.

Right hydroureteronephrosis due to ureteral stone (confirmed by ultrasound).

Case Discussion

The CT features are most consistent with small bowel carcinoid tumour with mesenteric and hepatic metastases.

Small bowel carcinoid tumours, also called small bowel neuroendocrine tumours (SBNETs) are considered the most common gastrointestinal neuroendocrine tumours and most frequently involve the terminal ileum.

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