56 year old presenting with a mediastinal and ovarian mass. During surgical excision, a small nodule was palpated in the jejunum and a capsular lesion detected in the liver.
-small intestinal carcinoids usually present with mets at time of presentation
-common to see greater amount of metastatic disease (either lymph nodes or liver) than primary tumor
-generally treated by complete surgical resection (chemotherapy usually not effective)
-Type A (nested growth pattern most common)
-tumor can cause hypertrophy of muscularis propria which, combined with local fibrosis, often leads to "kinking" of small bowel and obstruction
Liver : Carcinoid Tumor