Presentation
Abdominal pain, fatigue and weight loss.
Patient Data
Lobulated homogeneously enhancing soft tissue mass within the small bowel mesentery in the left lower abdomen encasing the SMA with a “spoke-like” appearance of mesenteric vessels and mild distortion of the adjacent small bowel loops. No calcification or necrotic component within. A small enhancing nodule (12 mm) of the adjacent bowel loop is noted (well-demonstrated on the arterial phase).
Numerous hypervascularised hepatic nodules, the largest are located in the segments, 7 (35 mm) and 6 (30 mm) with central necrosis.
Both lungs are clear (not shown).
A small left upper ureteral stone is noted with no significant hydronephrosis.
Case Discussion
CT features most consistent with small bowel carcinoid tumor with hepatic metastases.
The patient underwent an US-guided biopsy of the lesion located in the segment 6. The histopathological exam confirms the diagnosis of hepatic metastasis from a carcinoid tumor.