Computed tomography of malignant carcinoid disease

Area of Science:

• Oncology
• Radiology
• Gastroenterology

Background:

• Malignant carcinoid syndrome presents diagnostic challenges.
• Accurate staging and metastasis detection are crucial for patient management.

Purpose of the Study:

• To evaluate the utility of computed tomography (CT) in identifying primary tumors, adenopathy, and metastases in patients with malignant carcinoid syndrome.
• To assess the impact of contrast administration on lesion detectability in the liver.

Main Methods:

• Retrospective analysis of CT scans from 22 patients with malignant carcinoid syndrome.
• Evaluation of precontrast and contrast-enhanced scans, focusing on liver metastases.
• Comparison of CT findings with other imaging modalities and surgical findings.

Main Results:

• CT identified primary tumors or adenopathy in 4 of 22 patients.
• Mesenteric thickening or adenopathy was noted in post-resection scans of 16 patients.
• Malignant ascites was present in 7 of 21 patients.
• Hepatic metastases were hypodense on precontrast scans.
• Contrast administration variably affected lesion detectability, obscuring metastases in 8 of 21 scans.

Conclusions:

• Noncontrast liver scans are recommended for accurate assessment of hepatic metastases in malignant carcinoid syndrome when precise quantification is critical for therapy.
• CT plays a role in identifying primary tumors, local spread, and ascites in carcinoid syndrome.