Carcinoid tumor of the small intestine: multidetector computed tomography findings with pathologic correlation

Coulier, B; Pringot, Jacques; Gielen, Ingrid; Maldague, P; Broze, B.; Ramboux, A.; Clausse, Marylene

doi:10.1016/j.clinimag.2008.06.014

Cited by 6 publications

(9 citation statements)

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“…35 in a retro spective review of seven cases, in which multi detector CT and histological examinations were performed, the arterial phase of enhancement detected small tumors and areas of encasement or obstruction of small vessels, and was helpful to identify fibrosis. 36 …”

Section: Diagnosis Of Fibrosismentioning

confidence: 99%

Fibrosis and carcinoid syndrome: from causation to future therapy

Druce¹,

Rockall²,

Grossman³

2009

Nat Rev Endocrinol

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Carcinoid tumors are part of a heterogeneous group of gastrointestinal and pancreatic endocrine tumors that are characterized by their capacity to produce and secrete hormones, 5-hydroxytryptamine, tachykinins and other mediators. These substances are thought to be responsible for the collection of symptoms, which include diarrhea, flushing and wheezing, that is known as carcinoid syndrome. Fibrosis that occurs either local to or distant from the primary tumor is one of the hallmarks of carcinoid tumors that originate from the midgut. The fibrotic process can occur in the mesentery as a desmoplastic response and may lead to obstruction of the small bowel, but it can also occur in the lungs, skin or retroperitoneum. Importantly, up to one-third of patients develop cardiac valvulopathy. One or more products that are secreted by the tumor and enter into the circulation are likely to have a role in this process. This Review discusses the incidence and prevalence of fibrosis in carcinoid syndrome and explores evidence to date for causative agents, in particular the roles of 5-hydroxytryptamine and elements of the downstream signaling pathway. Improved understanding of the etiology of carcinoid-tumor-related fibrosis may lead to better treatments for this condition than those we currently have.

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Section: Diagnosis Of Fibrosismentioning

confidence: 99%

Fibrosis and carcinoid syndrome: from causation to future therapy

Druce¹,

Rockall²,

Grossman³

2009

Nat Rev Endocrinol

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“…Coulier B et al, reported analysis of the arterial phase of MDCT study appearing primordial to detect the sometimes very small but intensively enhancing primary tumor. 10 In this study, nodular enhancing masses were present in the ileum. Mesenteric lymph nodes with a desmoplastic reaction in the retroperitoneum was also seen.…”

Section: Discussionmentioning

confidence: 50%

Role of CT enterography in evaluation of small bowel disorders

Misra¹,

Bajaj²

2019

Int J Res Med Sci

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Background: Small bowel pathologies are an enigma for clinicians and difficult to assess and evaluate for clinicians. In order to establish the efficacy of MDCT Enterography in diagnostic characterisation of small bowel lesions, the current study was undertaken.Methods: A prospective observational cross-sectional study was carried out in a tertiary care hospital. 30 patients with clinically suspected small bowel disease underwent CT enterography using iso-osmotic mannitol as neutral enteral contrast. CT enterography diagnoses were compared with clinical, surgical and histopathological results.Results: CT enterography showed a sensitivity (95.83%), specificity (100%), positive predictive value (100%), negative predictive value (85.71%), accuracy (96.66%) in diagnosis of small bowel diseases.Conclusions: CTE is a non-invasive well tolerated and reliable imaging modality for the depiction of small-bowel diseases. It provides excellent visualization of luminal, mural and extraintestinal findings.

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“…Six months after surgery, the patient reported by Segu et al was in a good general condition, the patient reported by Valo et al died with mesenteric ischemia and septicemia (Segu et al, 1997;Valo et al, 2000). Coulier et al reported that 6 to 7 patients with neuroendocrine tumors of the small intestine / ileum without Cushing ' s syndrome or ACTH secretion had multiple mesenteric nodal metastases with 4 of those 7 having the nodal mesenteric metastases as major fi nding and much more prominent and larger than the primary tumor (Coulier et al, 2007). In addition to a neuroendocrine tumor of the ileum, there frequently is coexistence of a second primary tumor, for instance, a synchronous adenocarcinoma most commonly located in the large intestine (Gerstle et al, 1995;Reim et al, 2008;Sembawa et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Ectopic Cushing's Syndrome Caused by a Well Differentiated ACTH-Secreting Neuroendocrine Carcinoma of the Ileum

Singer

Werner²,

Koch³

et al. 2010

Exp Clin Endocrinol Diabetes

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Cushing's syndrome can be caused by adrenocorticotropic hormone-secreting solid tumors. We report a rare case of an ileal endocrine carcinoma that produced ACTH and induced hypercortisolism. A now 47-year-old man presented at age 41 with weight gain, tremor, perspiration, and general fatigue. Laboratory testing showed hypercortisolism and diabetes mellitus. Further examinations revealed ectopic Cushing's syndrome. The search for the primary tumor was difficult. The patient underwent subtotal thyroidectomy and surgical removal of a pituitary lesion. After resection of an ACTH-producing metastasis of the mesentery, temporary remission of Cushing's syndrome ensued. At the age 45 the primary tumor was detected in the ileum by Ga-68 DOTATOC-PET scan and explorative laparotomy. After surgical removal of this well differentiated neuroendocrine carcinoma the patient significantly improved clinically. He experienced better blood pressure and remission of his diabetes mellitus in addition to increased muscular strength. Endocrine laboratory testing at follow-up examinations confirmed remission of hypercortisolism and diabetes mellitus. A Ga-68 DOTATOC PET scan and a 1 mg dexamethasone suppression test 5 months after surgery showed normal results. Ectopic ACTH secretion within the small bowel is very rare. This case underscores the difficulty in locating the source of ectopic ACTH secretion and suggests using small bowel barium study, tubus endoscopy or video endoscopy for preoperative localization if the small bowel is suspected as tumor source.

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Carcinoid tumor of the small intestine: multidetector computed tomography findings with pathologic correlation

Cited by 6 publications

References 0 publications

Fibrosis and carcinoid syndrome: from causation to future therapy

Fibrosis and carcinoid syndrome: from causation to future therapy

Role of CT enterography in evaluation of small bowel disorders

Ectopic Cushing's Syndrome Caused by a Well Differentiated ACTH-Secreting Neuroendocrine Carcinoma of the Ileum

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