CASE 77 Published on 02.04.2000

Midgut carcinoid tumor


Abdominal imaging

Case Type

Clinical Cases


AS Rangheard, C Dromain, A Loshkajian, R Sigal


45 years, female

No Area of Interest ; Technique CT, CT
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).
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).
Differential Diagnosis List
midgut carcinoid tumor
Final Diagnosis
midgut carcinoid tumor
Case information
DOI: 10.1594/EURORAD/CASE.77
ISSN: 1563-4086