Mesenteric carcinoid tumor with small bowel ischemia

Case contributed by Dr Vardan Abrahamyan
Diagnosis almost certain

Presentation

A week of increasing abdominal pain, nausea, and vomiting.

Patient Data

Age: 75 years
Gender: Male

Small mesenteric solid mass of 1.8 x 1.2 x 1.1 cm, with a dot of calcification. Distal ileum ischemic changes with relatively reduced wall enhancement. The jejunum and proximal ileal loops are dilated to 3.8 cm. Mild free fluid.

Incidental finding: two-side nephrolithiasis, without hydronephrosis, and renal cysts. No visible metastasis in the liver.

 The blue circle is mesenteric carcinoid. Red and green triangles show the difference between the blood flow of the small bowel.

Case Discussion

The patient was operated on, the tumor was removed, and an 80 cm ischemic ileum segment was resected. The histopathological study demonstrated a mesenteric neuroendocrine carcinoid tumor.

Gastrointestinal neuroendocrine tumors, commonly called carcinoids, are relatively rare. Symptoms associated with intestinal ischemia may be the only manifestation in patients with carcinoid tumors. This tumor may be small, and intestinal complications can be prevented by early diagnosis and removal of the tumor.

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