Abstract
Background. A 48-year-old man presented with diarrhea, flushing, abdominal pain and weight loss of 10 kg over a 6-month period. He subsequently developed dyspnea on exertion.
Investigations. Physical examination, laboratory tests, CT of the abdomen, liver biopsy, echocardiography, immunohistochemistry staining of the biopsy specimen for neuroendocrine markers including chromogranin A, synaptophysin and protein gene product 9.5, and 111In-pentetreotide scintigraphy (Octreoscan™).
Diagnosis. Carcinoid tumor of midgut origin with large segment 3 liver metastasis. Carcinoid syndrome and carcinoid heart disease.
Management. Symptomatic relief with somatostatin analog therapy and subsequent resection of the segment 3 liver metastasis. Tricuspid and pulmonary valve replacement.
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Acknowledgements
Désirée Lie, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.
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Bhattacharyya, S., Gujral, D., Toumpanakis, C. et al. A stepwise approach to the management of metastatic midgut carcinoid tumor. Nat Rev Clin Oncol 6, 429–433 (2009). https://doi.org/10.1038/nrclinonc.2009.70
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DOI: https://doi.org/10.1038/nrclinonc.2009.70
