Carcinoid

Carcinoid tumor is the most common neoplasm of the small intestine found at autopsy or incidentally during la-parotomy. Almost 90% of lesions are located in the distal ileum, they may be multiple in approximately one third of cases, while coexistence with other primary malignancies is estimated to occur in another third of cases. The radio logical findings mirror the stage that the pathological process has reached at the time of examination. Primary ileal carcinoids usually feature as solitary, round, sharply-demarcated intramural filling defects. Luminal narrowing, usually asymmetrical, is present less often, whereas intestinal obstruction or intussusception is uncommon. Submucosal extension of the tumor will result in thickening of the valvulae conniventes and intestinal wall thickening. In the presence of extensive mesenteric fibrosis, diffuse luminal narrowing, fixation, angulation or kinking of intestinal loop(s) are also demonstrated. Carcinoid tumors are best recognized on CT on the basis of mesenteric findings. These include a discrete, uniform, soft tissue mass occasionally associated with linear soft tissue strands radiating into the surrounding mesentery in a stellate pattern, while displacing adjacent intestinal loops. Segmental intestinal wall thickening, ascites, hypervascular liver metastases, that are usually hypodense on precontrast scans, and occasionally dystrophic calcification in metastatic nodes or in liver metastases, may be also encountered.

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