CASE 77 Published on 02.04.2000

Midgut carcinoid tumor

Section

Abdominal imaging

Case Type

Clinical Cases

Authors

As rangheard, C Dromain, A Loshkajian, R Sigal

Patient

45 years, female

Categories
No Area of Interest ; No Procedure ;
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).
Differential Diagnosis List
midgut carcinoid tumor
Case information
URL: https://www.eurorad.org/case/77
DOI: 10.1594/EURORAD/CASE.77
ISSN: 1563-4086