title: Carcinoid syndrome from small bowel endocrine carcinoma in the absence of hepatic metastasis.
abstract: An 80-year-old male patient presented with abdominal pain, paroxysmal diaphoresis, diarrhoea and vomiting. CT scan revealed a small bowel endocrine carcinoma (or 'carcinoid' tumour), but the absence of hepatic disease. The lesion was excised 'en-bloc'. Intra-operatively, there was wide fluctuation in blood pressure associated with tumour manipulation, with hyper- and hypotension. Carcinoid syndrome usually occurs from gastrointestinal tumours when hepatic metastases occur, causing flushing, diarrhoea, bronchoconstriction and murmurs from cardiac valvular lesions. This patient did not have radiological evidence of hepatic metastasis, but the syndrome could still occur with midgut tumours via local invasion of the retroperitoneal circulation, or by action of substances other than serotonin that do not undergo hepatic metabolism.
authors: University Hospitals Coventry and Warwickshire, UK. Andrea.Lovell@uhcw.nhs.uk
authors: Sayan
authors: S
authors: Datta
authors: Nigel
authors: N
authors: Williams
authors: Sari
authors: S
authors: Suortamo
authors: Asif
authors: A
authors: Mahmood
authors: Colin
authors: C
authors: Oliver
authors: Nicholas
authors: N
authors: Hedley
authors: Pijush
authors: P
authors: Ray
mesh_terms: D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D013505:Digestive System Surgical Procedures; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008303:Malignant Carcinoid Syndrome / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome