The most common sites of metastasis from midgut carcinoid tumors are mesenteric lymph nodes and the liver. Metastases to the lung, peritoneum, bone, and pancreas are less common. Rare sites of metastasis include soft tissues (, 17), the breast (, 18), and the orbit (, 19). Radiologic Features of Carcinoid Tumor All results were reviewed independently. Clinical picture at follow-up and further imaging and/or histological studies confirmed or excluded the diagnosis of the disease. Results: Twenty nine patients were diagnosed with carcinoid tumor. Liver metastases were found in 26 patients and lymph node metastases were detected in 18 of them .5 cm in size. Metastases, commonly to the mesentery, liver, and lymph nodes, often exceed the size of the primary neoplasm. Multiple primaries and metachronous tumors in other organs can often occur 3 Abstract. PURPOSE: To evaluate triple-phase helical computed tomography (CT) of carcinoid liver metastases. MATERIALS AND METHODS: Triple-phase helical CT was performed in 31 patients with proved carcinoid liver metastases. Hepatic arterial-dominant phase (HAP) and portal venous-dominant phase (PVP) images were obtained 20 and 70 seconds after.
The typical presentation of a carcinoid in the bronchopulmonary system and gastrointestinal tract (with liver metastases) is well known in the radiologic literature. However, involvement of other sites, such as the head, neck, breast, and/or genitourinary tract, is not uncommon Typical CT appearance of a mesenteric carcinoid tumor with classic desmoid reaction. The focal hepatic lesions representing metastases. The hepatic mass was biopsied and was consistent with a carcinoid tumor metastasis In patients with suspected gastrointestinal carcinoid, the imaging studies that are currently recommended include chest radiography or CT, CT of the abdomen and pelvis, and 111 In-diethylenetriamine pentaacetic acid (DTPA) octreotide scintigraphy [ 29 ] The most common metastatic sites are the liver, lymph nodes, bone, lung, and peritoneal cavity. Hepatic metastases and the degree of liver involvement are considered major prognostic factors for survival in patients with neuroendocrine tumors [ 1, 2, 3 ] Neuroendocrine tumors (NETs) (historically called APUDomas) represent a wide spectrum of disease.They consist of a large heterogeneous group of malignancies that are derived from embryonic neural crest tissue found in various organ such as the hypothalamus, pituitary gland, thyroid gland, adrenal medulla, and gastrointestinal tract
The Role of Interventional Radiology for the Treatment of Hepatic Metastases from Neuroendocrine Tumor: An Updated Review Maxime Barat 1,2,* , Anne-Ségolène Cottereau 2,3, Alice Kedra 1, Solène Dermine 2,4, Lola-Jade Palmieri 2,4, Romain Coriat 2,4, Raphael Dautry 1, Lambros Tselikas 5, Philippe Soyer 1,2 and Anthony Dohan 1, 2. To present the MR and CT imaging findings of gastrointestinal carcinoid tumors with special attention to the detection of the primary tumor, desmosplastic reaction and metastatic disease. Clinical Background • Carcinoids are malignant neuroendocrine tumors arising from enterochromaffin cells of Kulchitsky in the crypts of Lieberkuhn Survival after diagnosis of primary tumor, diagnosis of hepatic metastases, and first chemoembolization was 81, 47, and 24 months, respectively. Eight patients were alive at the end of the study. No mortality was related to chemoembolization. CONCLUSION: Chemoembolization is safe and effective for palliation of carcinoid liver metastases
Carcinoid metastases The likelihood of metastases is related to the size of the tumor. For example, the incidence of nodal and liver metastases is approximately 20-30% in patients with carcinoid tumors smaller than 1 cm but increases to almost 60-80% for nodal metastases and 20% for liver metastases when tumors are 1-2 cm Although a relatively rare neoplasm, primary carcinoid tumor has an unusual propensity to metastasize to the orbits. Within the orbit, metastatic EOM lesions have been described in scattered reports in the ophthalmology literature but have received little to no attention in the radiology literature The objective of this study was to describe the imaging findings of carcinoid tumors metastatic to the breast, with pathologic and clinical correlations. We searched our surgical database for cases of pathologically proven carcinoid tumors metastatic to the breast from October 1, 2000, to May 31, 20
Carcinoid metastases to the liver have a characteristic CT appearance because of their vascularity . On early (arterial) phase imaging after the administration of an IV contrast agent, these metastases enhance brightly. On delayed imaging, these lesions may become isodense with the liver parenchyma The carcinoid syndrome was first characterized by Thorson et al 16 in 1954 and is classically described as flushing, diarrhea, valvular heart disease, and bronchospasm, in order of decreasing frequency. 10,17,18 Other clinical signs variably attributed to the carcinoid syndrome include telangiectasias, cyanosis, pellagra-like dermatitis. Introduction. Evaluation of liver metastases is one of the most common indications for magnetic resonance (MR) imaging of the liver. Metastases are the most common malignant liver lesions and are about 18-40 times more common that primary liver tumors .It has been established that complete surgical resection of liver metastases prolongs survival in eligible surgical candidates The most common metastatic sites are the peritoneal surfaces of the pelvis and abdominal cavity, and ovaries in women. Surgery is the main form of treatment in patients with GCC. Case presentation: A 49-year-old woman was treated at the Institute of Oncology and Radiology of Serbia with histopathological findings of GCC. In a 8-year period the.
Liver metastases from carcinoid. Case contributed by Dr Natalie Yang . Diagnosis almost certain. Diagnosis almost certain. Note: This case has been tagged as legacy as it no longer meets image preparation and/or other case publication guidelines. From the case: Liver metastases from carcinoid. CT Carcinoid Tumor Metastases to the Extraocular Muscles: MR Imaging and CT Findings and Review of the Literature A. Gupta J.L. Chazen C.D. Phillips SUMMARY: Although a relatively rare neoplasm, primary carcinoid tumor has an unusual propensity to metastasize to the orbits. Within the orbit, metastatic EOM lesions have been described in scattere The hypervascular nature of carcinoid tumors and their metastases allows a more aggressive role by the radiologist in diagnosis and interventional management. Double-contrast gastrointestinal studies still best define the primary neoplasms The diagnosis of liver metastases was established by histopathology (surgical excision or needle biopsy) in 13 patients and by imaging and clinical follow-up (newly developed liver lesions, laboratory values of hormone levels, and carcinoid syndrome) in 5 patients In one patient (Case 8), thymic carcinoid and spinal metastases were detected on chest CT and lumbar spine MRI during the examination for back pain. The remaining one patient with multiple endocrine neoplasia Type 1 (MEN1) (Case 11) had a history of surgery for pancreatic insulinoma and parathyroid tumour
Recognition of carcinoid metastases to the breast in patients with known or occult primary carcinoid tumors is important to avoid unnecessary treatment for primary breast cancer. AB - The objective of this study was to describe the imaging findings of carcinoid tumors metastatic to the breast, with pathologic and clinical correlations 3.Discussion. Patients with testicular carcinoid tumors usually present with a self-detected testicular mass or testicular ache (as occurs with common testicular tumors) or, rarely, carcinoid syndrome (red-hot flushing, diarrhea, abdominal pain, palpitations, and bronchospasms) if there is metastasis to the liver or lungs The aim of the present study was to evaluate the ocurrence of bone metastases in patients with metastatic carcinoid tumours, and the role of various nuclear medicine modalities (bone scintigraphy. s. Subcutaneous metastases of carcinoid tumors are extremely rare; there are only few cases reported in the literature and the site of the primary tumor was mainly the gastrointestinal tract. Also, the diagnosis of this type of lesions many years after the surgical resection of the pulmonary carcinoid (PC) could be a challenge for clinicians. Patient concerns: A nonsmoker woman diagnosed with. Usually there are omental metastases, i.e. omental cake and ascites. NHL and lymph node metastases Are the most common diagnoses of a mesenteric mass. NHL is the most common cause of lymphadenopathy and usually there are other sites with lymphoma. Carcinoid Presents as a spiculated mesenteric mass often with a central calcification
Ovary tumor - Carcinoid tumor metastatic to ovary. Insular pattern is the most frequently observed; mucinous and trabecular patterns have also been reported (Cancer 1975;36:157, Int J Gynecol Pathol 2008;28:41) Insular architecture is characterized by sharply demarcated nests of tumor cells of varying sizes and shapes in a variable fibromatous strom People with carcinoid tumors have excess levels of a chemical in their urine that's produced when the body breaks down hormones secreted by carcinoid tumors. Imaging tests. Imaging tests, including a computerized tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET), X-ray and nuclear medicine scans, may. Indium-111-labeled somatostatin receptor imaging has been used to localize carcinoid tumors and to visualize carcinoid tumor myocardial metastases with great clinical utility. In addition to localization of the carcinoid tumor, radiopharmaceutical uptake has been correlated with tumor responsiveness to somatostatin therapy
Side effects and complications after hepatic artery embolization in the carcinoid syndrome. Scand J Gastroenterol 1991, 26, 557-562 Twenty patients with histologically verified carcinoid liver metastases underwent a total of 24 liver artery embolizations by means of interventional radiologic techniques. There were no deaths Carcinoid brain metastases are extremely rare and are associated with a poor prognosis. Treatment options are variable, ranging from surgery, radiation, or chemotherapy alone or combined. We report on a case of rectal carcinoid metastatic to the cerebellum and review chemotherapeutic regimens for carcinoid tumor treatment, focusing on the potential role of temozolomide or stereotactic. I METASTATIC CARCINOID TUMORS — Regardless of primary site, carcinoid tumors are characterized by a strong propensity to metastasize to the liver . Patients with liver metastases may experience symptoms related to tumor burden (eg, pain, jaundice, early satiety) or hormonal symptoms (eg, flushing and diarrhea) Unusual Osteoblastic Metastases from Carcinoid Tumors Unusual Osteoblastic Metastases from Carcinoid Tumors Peavy, Patrick W.; Rogers, James V.; Luther Clements, J.; Bricker Burns, J. 1973-05-01 00:00:00 Two cases of metastatic bronchial carcinoid tumors with two distinctive patterns of osteoblastic bony metastases are presented and discussed in context with the current literature
Figure 1. 18 F-Fluorodihydroxyphenylalanine (FDOPA) PET/CT, cardiac contrast-enhanced CT, and magnetic resonance imaging (MRI) in a 43-year-old patient with metastatic grade-2 neuroendocrine tumor (NET). Two distinct foci of pathologically increased uptake suggesting heart metastases (arrows) were showed on 18 F-FDOPA PET/CT in lateral and anterior wall of left ventricle Ganeshan D, Bhosale P, Yang T, Kundra V. Imaging features of carcinoid tumors of the gastrointestinal tract. AJR Am J Roentgenol 2013; 201:773. Paulson EK, McDermott VG, Keogan MT, et al. Carcinoid metastases to the liver: role of triple-phase helical CT. Radiology 1998; 206:143 Carcinoid tumors have high potential for metastasis. These cells produce a significant amount of beta-catenin, which enables the tumor cell adhesion, thus promoting metastasis. Induction of Raf1. INTRODUCTION. Neuroendocrine tumors (NET) are rare neoplasms derived from enterochromaffin cells. They are primarily found in the gastrointestinal tract and lungs. 1 The most common metastases site is the liver, followed by lungs, bone, and adrenals. 2 With increasing survival, unusual sites of metastases such as orbit/extraocular muscles have emerged. . Most patients with orbit metastases had.
Imaging. CT with multiphase contrast study, MRI, somatostatin receptor scintigraphy with Octreoscan and PET scan with DOTATOC are useful imaging modalities for localizing carcinoid tumors and assessing metastatic spread. CT is insensitive for small liver metastases for which MRI with hepatocyte-specific contrast agent is a better imaging modality A 76-year-old male with a small bowel neuroendocrine tumor with hepatic metastases presented with new onset lower extremity swelling, bloating, and weight gain which ultimately lead to cardiac magnetic resonance (CMR) to evaluate for cardiac involvement of disease. CMR showed right and left ventricular myocardial metastases along with findings suggestive of carcinoid heart disease .4 This patient had hepatic metastasis. References 1. Feldman, J.M. & Scott-Jones, R. Carcinoid syndrome 4
Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome. Definition (NCI_CDISC) A neuroendocrine neoplasm arising from enterochromaffin cells in the gastrointestinal tract and (less common) the bronchi with undetermined malignancy status Malignant carcinoid syndrome is characterized by an array of signs and symptoms—in particular, hot, red flushing of the face; severe and debilitating diarrhea; and asthma attacks—caused by vasoactive hormones secreted by metastases from carcinoid tumors. [1, 2, 3] Carcinoid tumors are of neuroendocrine origin and derive from primitive stem cells, which can give rise to multiple cell lineages
• Carcinoid tumors are composed of monotonous sheets of small round cells with uniform nuclei and cytoplasm, and mitotic figures are rare. • Pathologists cannot differentiate benign from malignant carcinoid tumors based on histologic analysis. • Malignancy can only be determined if there is invasion or distant metastases 7 Interventional radiology plays an important role in the management of patients with neuroendocrine tumor liver metastasis (NELM). Transarterial embolization (TAE), transarterial chemoembolization (TACE), and selective internal radiation therapy (SIRT) are intra-arterial therapies available for these patients in order to improve symptoms and overall survival Carcinoid tumorlet : Well differentiated neuroendocrine tumor with size < 5mm and with < 2 mitoses/2 mm 2 and absence of necrosis. Small cell carcinoma : Scant cytoplasm, elevated nuclear to cytoplasmic ratio, nuclear molding, absence of nucleoli. Ki67 proliferative index > 50%. Large cell neuroendocrine carcinoma : Large cells, high grade nuclei Carcinoid syndrome is caused by a neuroendocrine (carcinoid) tumor, and that may lead to liver dysfunction and death in cases where the cancer has spread (metastasized). Still, this is a cancer that responds to treatment and even in advanced stages, the five-year survival rate is almost 70 percent. Early diagnosis leads to a 97 percent survival rate Other diagnostic imaging: Computed tomography (CT) is of poor utility in detecting primary carcinoid tumors but is helpful in evaluating the extent of tumor spread before surgical exploration. An abdominal magnetic resonance imaging (MRI) scan may be performed to detect metastases of carcinoid syndrome to the liver and mesentery 
Management of Metastatic Small Intestinal Carcinoid Tumor (Grade 1) Without Carcinoid Syndrome. A watch-and-wait approach is an initial option for the patient with low bulk asymptomatic metastatic grade 1 small intestinal NETs presenting without carcinoid syndrome. Serial biochemical measurements (eg, urinary/plasma 5-HIAA and. While the most compelling levels of evidence for the use of Yttrium-90 (90Y) radioembolization are in patients with hepatocellular carcinoma and hepatic metastases from colorectal cancer, a growing body of literature supports its use in other primary and secondary hepatic malignancies. This includes intrahepatic cholangiocarcinoma, as well as hepatic metastases from neuroendocrine cancer. ciated symptoms, likelihood of metastasis, and commonness of carcinoid syndrome for carcinoid tumors in different locations of the body. MRI = magnetic resonance imaging Ga DOTATATE PET/CT imaging in the evaluation of somatostatin-receptor density within neuroendocrine tumor metastases. The 10-minute, single-bed, whole-body images acquired with Biograph Vision Quadra's 106 cm axial PET FoV helped define metastatic burden and inform radionuclide therapy plans that involved the use of DOTATATE-labeled ligands
Nuclear imaging with somatostatin analogues reveals increased tracer activity in these tumors and their metastases. (4) Treatment. The treatment is complete surgical excision. References: 1. Scarsbrook AF, Thakker RV, Wass JA et-al. Multiple endocrine neoplasia: spectrum of radiologic appearances and discussion of a multitechnique imaging approach This type of PET scan is useful in finding high-grade (grade 3) carcinoid tumors, but a newer type of PET scan, called a Gallium-68 PET/CT Dotatate scan is being used for low (grade 1) or intermediate-grade (grade 2) GI carcinoid tumors. It uses the radioactive agent gallium-68 dotatate which attaches to the somatostatin protein on carcinoid cells
Computed tomography. CT is considered the best imaging procedure for the evaluation of patients with known or suspected peritoneal metastases. The use of intraperitoneal positive contrast and pneumoperitoneum with CT has been suggested to improve the detection of small peritoneal metastases but these techniques do not routinely opacify all the peritoneal recesses[2-4] Intracranial spread of a systemic malignancy is common in advanced staged cancers; however, metastasis specifically to the pineal gland is a relatively rare occurrence. A number of primary lesions have been reported to metastasize to the pineal gland, the most common of which is lung. However, metastasis of a bronchial neuroendocrine tumor to the pineal gland is a seldom-reported entity Neuroendocrine tumours frequently metastasize to the liver. Although generally slowly progressing, hepatic metastases are the major cause of carcinoid syndrome and ultimately lead to liver dysfunction, cardiac insufficiency and finally death. A literature review was performed to define the optimal treatment strategy and work-up in patients with neuroendocrine hepatic metastases Classification of Gastroenteropancreatic Neuroendocrine Tumors. Most neuroendocrine metastases to the liver are of GI or pancreatic origin, so-called gastroenteropancreatic (GEP) tumors (Rindi et al, 1998).GEP neuroendocrine tumors have historically been divided into two broad types, carcinoid and noncarcinoid, either of which may or may not be associated with hormone production that causes a. The heart is an exceedingly rare site of metastatic involvement in carcinoid tumors. Only nineteen cases have been described in the literature over the past 30 years. We report here on a patient who presented with progressive carcinoid syndrome despite surgical resection of her liver metastases. She was found to have cardiac metastases on inidium-111-pentetreotide scintigraphy and subsequently.
Metastatic Carcinoid Tumors. There are many types of cells throughout the body. Some of these cells are called neuroendocrine cells.These cells are unique because they affect both the nervous system and the endocrine system.. The nervous system helps send signals out across nerve pathways that control things like movement. The endocrine system helps regulate hormones in your body Neuroendocrine tumors (NETs), also known as carcinoid tumors, are a heterogeneous group of neoplasms that arise from cells throughout the neuroendocrine system, most commonly arising from the gastrointestinal (GI) tract, lungs, and bronchi. Myocardial carcinoid metastasis is rare with an incidence among metastatic carcinoid patients of 4%. They are generally asymptomatic and detected incidentally Orbital ultrasonography, computed tomography, and magnetic resonance imaging revealed a large, well-circumscribed orbital mass involving the superior rectus muscle. The surgically excised tumor was studied by light microscopy, histochemistry, and transmission electron microscopy. These studies confirmed the diagnosis of carcinoid tumor Metastases to the spleen are extremely rare, but have been reported from a number of primary malignancies, such as breast cancer, lung cancer, melanoma and ovarian cancer. This is the first report of a splenic metastasis from a primary pancreatic neuroendocrine tumor. The patient presented as a 53 years old white male with anemia and fatigue Carcinoid Tumors. WILLIAM J. GEIGER, M.D., and NANCY B. DAVIS, M.D., Medical College of Wisconsin, Milwaukee, Wisconsin. Am Fam Physician. 2006 Aug 1;74 (3):429-434. Carcinoid tumors are rare.
Primary neuroendocrine tumor is a rare, distinct and aggressive malignancy, which comprises about 2% to 5% of the breast cancers using the WHO criteria. Lymph node and distant metastasis is frequent and the prognosis is usually poor, similar to its pulmonary counterpart. Patients may do well, if detected in the early stage of the disease Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Carcinoid Tumor. link. Bookmarks (0) Gastrointestinal. Diagnosis. Small Intestine. Malignant Neoplasms. Carcinoid Tumor. Biopsy-proven neuroendocrine tumor. Measurable metastasis to liver with at least one dimension ≥ 1.0 cm. MD, is a Professor of Clinical Radiology at the University of California, San Francisco and UCSF Mount Zion. Dr. Fidelman received his medical degree from UCSF in 2002, and completed his residency in Diagnostic Radiology from UCSF in. Side effects and complications after hepatic artery embolization in the carcinoid syndrome. Scand J Gastroenterol 1991, 26, 557-562 Twenty patients with histologically verified carcinoid liver metastases underwent a total of 24 liver artery embolizations by means of interventional radiologic techniques. There were no deaths Enlarge Gastrointestinal carcinoid tumors form in the lining of the gastrointestinal tract, most often in the appendix, small intestine, or rectum.. Gastrointestinal carcinoid tumors form from a certain type of neuroendocrine cell (a type of cell that is like a nerve cell and a hormone-making cell).These cells are scattered throughout the chest and abdomen but most are found in the GI tract
Carcinoid tumors in the lungs. Signs and symptoms of carcinoid lung tumors include: Chest pain. Wheezing. Shortness of breath. Diarrhea. Redness or a feeling of warmth in your face and neck (skin flushing) Weight gain, particularly around the midsection and upper back. Pink or purple marks on the skin that look like stretch marks Initial evaluation of dual-energy computed tomography as an imaging biomarker for hepatic metastases from neuroendocrine tumor of the gastrointestinal tract Eddiel Cruz-Hernández 1 , Usman Mahmood 2 , Jennifer S. Golia Pernicka 3 , Viktoriya Paroder 3 , Iva Petkovska 3 , Marc J. Gollub 3 , Jinru Shia 4 , Karuna Ganesh 5 , David D. B. Bates 3 Carcinoid heart disease is a frequent occurrence in patients with carcinoid syndrome and is accountable for substantial morbidity and mortality. The pathophysiology of carcinoid heart disease is not well understood; however, chronic exposure to excessive circulating serotonin is considered one of the most important contributing factors
Biomarker testing to confirm carcinoid syndrome In addition to imaging, it's important to test for biochemical markers associated with carcinoid syndrome in order to make an accurate diagnosis.1,9,10 When carcinoid syndrome is suspected, there are 2 types of tests that may be used for confirmation: diagnostic imaging and biomarker tests.1- He had a medical history of bronchial carcinoid, having undergone left pneumonectomy 20 years earlier, and was diagnosed with stage IV disease (bone and liver metastasis). A 68 Ga-DOTATOC positron emission tomography (PET) scan in July 2019 was notable due to two foci of abnormally high radionuclide uptake at the left inferolateral aspect of. A 54-year-old woman presented with a history of small bowel carcinoid neuroendocrine tumor metastatic to the liver. She had undergone multiple radiofrequency ablation and transarterial embolization (TAE) procedures since 2006, with hepatic arterial access complicated by dissection/chronic occlusion of the common hepatic artery Radiographic imaging includes cross-sectional imaging with triple-phase Computerized tomography scan, Magnetic Resonance Imaging, and somatostatin receptor scintigraphy. Abdominal CT (with triphasic CT of the liver) is the diagnostic test of choice. Surgery plays a vital role in the treatment of carcinoid syndrome with or without metastases.
Magnetic resonance imaging (MRI) and positron emission tomography (PET) scans may help differentiate between benign versus malignant tumors by detecting areas of metastasis (if any) Octreotide scintigraphy can help detect functional neuroendocrine tumor, and in some cases, liver metastasis Neuroendocrine tumours and carcinoid syndrome. Neuroendocrine tumours (NETs) are rare tumours of the neuroendocrine system, the system in the body that produces hormones. They can be cancerous or non-cancerous. The tumour usually grows in the bowels or appendix, but it can also be found in the stomach, pancreas, lung, breast, kidney, ovaries or.
Metastatic carcinoid tumors can be diagnosed by CT or MRI scans, indium 111 octreotide scans, and bone scans. MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation Occasionally, with carcinoid tumor of lung, a bone marrow biopsy is used to detect blood abnormalities, or if a physician believes that metastasis to the bone marrow may have occurred A biopsy refers to a medical procedure that involves the removal of cells or tissues, which are then examined by a pathologist Carcinoid tumors of the gastrointestinal tract. A review and the Duke University institutional overview. Carcinoid tumors: iodine-131 MIBG scintigraphy. Carcinoids associated with multiple endocrine neoplasia syndromes. Carcinoids of unknown origin: comparative analysis with foregut, midgut, and hindgut carcinoids Carcinoid syndrome is a rare condition characterized by a number of systemic symptoms, including a rapid heart rate, trouble breathing, flushing, and diarrhea. It occurs when a rare type of tumor called a carcinoid tumor produces excess hormones that have effects throughout the body. Carcinoid syndrome is diagnosed with blood and urine tests.