Midgut carcinoid tumor

Author(s)

AS Rangheard, C Dromain, A Loshkajian, R Sigal

Patient

female, 45 year(s)

Clinical History

flushes, diarrhea, palpitations and abdominal pain.

Imaging Findings

A 45-year old woman was admitted to the hospital with a 4 months history of flushing associated to diarrhea, palpitations and abdominal pain. The abdominal examination showed a nodular hepatomegaly. Biologically was found an urinary 5-HIAA excretion (normal ranged from 10 to 80 umol/24 h). An ultra-sonography and an abdominal computed tomography (CT) were performed. CT exploration : After administration of an oral contrast medium, a dual-phase helical CT was performed : before and after injection of a iodine contrast medium (100 ml).

Discussion

Carcinoid tumors arise from the bowel distal to the ligament of Treitz(1).Their typical manifestion is the carcinoid syndrome with flush, diarrhea and palpitations(3), associated to an urinary 5- HIAA excretion(2). Carcinoid tumors tend to metastasize to liver, bone and lung (1). Hepatic metastases are hypervascular: isodense relative to the liver, and become hyperdense after injection of a iodine contrast medium (1). The primary tumor is not always identified on CT examination because of its relatively small size(4).When it is seen, it appears as a soft tissue mass involving the bowel, or a focal bowel wall thickening. CT frequently reveals secondary mesentery changes as masses associated with radiating soft tissue strandS (1;4).

Final Diagnosis

References

Citation

AS Rangheard, C Dromain, A Loshkajian, R Sigal (2000, Apr 3).

Midgut carcinoid tumor, {Online}.

URL: http://www.eurorad.org/case.php?id=77

DOI: 10.1594/EURORAD/CASE.77

ISSN: 1563-4086

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Published 03.04.2000
DOI 10.1594/EURORAD/CASE.77
Section Abdominal Imaging
Case Type Clinical Cases
Views 101154
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Figure 1
Liver metastases

a

b

Tomodensitomètrie spiralée Coupe TDM axiale montrant de multiples lésions hépatiques de densité intermédiaire, certaines présentant un centre hypodense en rapport avec de la nécrose.

Area of Interest: unknown; Imaging Technique: Liver metastases;

Tomodensitomètrie spiralée Coupe TDM axiale après injection de produit de contraste iodé (temps précoce) révélant un important rehaussement des lésions hépatiques.

Area of Interest: unknown; Imaging Technique: Liver metastases;
Figure 2
Mesenteric mass

a

b

Tomodensitomètrie spiralée Coupe TDM axiale après contraste révélant une masse mésentérique avec des extensions radiaires. Pas d'adénomégalie, pas d'épanchement péritonéal.

Area of Interest: unknown; Imaging Technique: Mesenteric mass;

Tomodensitomètrie spiralée Mêmes éléments. Les extensions radiaires ne sont pas visibles sur cette coupe.

Area of Interest: unknown; Imaging Technique: Mesenteric mass;