Small bowel/mesenteric carcinoid

Case contributed by Michael P Hartung
Diagnosis probable

Presentation

Trauma scan. Patient notes nearly 1 year of difficult to control blood pressure.

Patient Data

Age: 55 years
Gender: Male

Small oval, enhancing lesion in the right lower quadrant adjacent to loops of ileum. Stranding of the adjacent mesentery. Multiple low attenuation liver lesions. No adenopathy. 

Case Discussion

Classic appearance for a small bowel or (rarely) mesenteric carcinoid. The small enhancing nodule adjacent to the ileum (and possibly within the mesentery) represents the often not-visible primary mass. The adjacent stranding represents the characteristic desmoplastic reaction in the mesentery. The liver lesions are suspicious for metastases, especially given the history of "difficult to control blood pressure", which suggests carcinoid syndrome. 

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