Mesenteric carcinoid tumor

Case contributed by Assis Prof Faeze Salahshour

Presentation

Abdominal pain for a few months, on CT scan mesenteric tumor, suggests. The patient underwent an explorative laparotomy, but except for a few inflamed small bowel loops, no other abnormality was found. He underwent MRE to exclude IBD.

Patient Data

Age: 45 years
Gender: Male
MRI

An enhancing mesenteric mass is seen encasing the ileocolic trunk of superior mesenteric vessels. Congested tortuous venous collaterals are seen in the more peripheral parts of the mesentery at the same level, secondary to the proximal mesenteric venous encasement. Few retro-pancreatic lymphadenopathies are seen in favor of lymphatic spread. On scrutinized reviewing, a small polypoid lesion is seen in one of the ileal loops in the mesenteric mass's proximity.

Annotated image

The brown and the orange arrows point to the mesenteric mass and congested mesenteric venous collaterals, respectively. The white shows the retro-pancreatic lymphadenopathies, and the black depicts an ileal polypoid lesion.

Case Discussion

 Carcinoid tumor, desmoid tumor, lymphoma, and mesenteric peritoneal implant are in DDX of mesenteric masses. On scrutinized reviewing, a small polypoid lesion is hardly visible in one of the ileal loops in the mesenteric mass's proximity, which could be the primary ileal carcinoid tumor. The mesenteric mass contains calcified foci on CT scan images (not available for uploading), increasing the likelihood of carcinoid tumors. The inflamed small bowel loops on surgery represent congested ileal loops, secondary to the mesenteric venous encasement. Octreotide scan suggests for further evaluation. Unfortunately, follow-up and additional data are not available.

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Case information

rID: 82373
Published: 17th Oct 2020
Last edited: 21st Oct 2020
Inclusion in quiz mode: Included
Institution: Tehran University of Medical Sciences (TUMS)

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