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Small bowel carcinoid tumor

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Abdominal pain, fatigue and weight loss.

Patient Data

Age: 60 years
Gender: Male
ct

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.

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