Presentation
Acute abdominal pain
Patient Data
There is a mesenteric mass with calcification in the mid abdomen. There is surrounding desmoplastic reaction.
Fecalisation and dilatation of small bowel loops adjacent to this is suggestive of small bowel obstruction.
Thickened loops of small bowel adjacent to the mass are appreciated.
Small amount of pelvic free fluid.
Case Discussion
Small bowel is the most common site for carcinoid tumors of the gastrointestinal tract. These are neuroendocrine tumors arising from the enterochromaffin cells with the gastrointestinal tract.
Carcinoid syndrome can occur, however is rare when there are no liver metastases due to portal drainage and metabolism of the vasoactive secretion. The exception is in bronchial carcinoid as they drain into systemic circulation.
Ga-Dotatate can be performed to confirm site of carcinoid. This patient received resection prior to nuclear medicine due to the associated complication of small bowel obstruction.