- 55 y.o. male with dx of metastatic WD G2 NET (liver biopsy, Ki 67=8.2%, unknown primary) with carcinoid syndrome, currently on SSA injection.
- Oncologic hx:
Weight loss and ongoing diarrhea prompted CT A/P 18 months prior which showed innumerable hepatic lesions including a dominant lesion occupying majority of the right hepatic lobe measuring up to 14.6 cm. Also a mildly hyperdense U-shaped mass in the root of the mesentery, which was thought to represent an enlarged lymph node. Biopsy of a liver lesion showed metastatic well differentiated neuroendocrine tumor, grade 2 Ki 67=8.2%. DOTATATE PET showed DOTA-avid disease in the liver, mediastinal and mesenteric LN, could not identify primary site. Patient started monthly octreotide injections on - CT CAP
- showed overall stable disease.
- Interim History:
Pt has no acute complaints. other than diarrhea. Taking imodium daily for control of stools. Denies abdominal pain.
18 Months prior
Liver Metastases – Some Necrotic
18 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows a necrotic mass in the right lobe with multiple other foci of metastasis throughout the liver
Ashley Davidoff TheCommonVein.net 124H 135894
18 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows a necrotic mass in the right lobe with multiple other foci of metastasis throughout the liver
Ashley Davidoff TheCommonVein.net 124H 135895
Tricuspid Stenosis
12 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart shows thickened tricuspid valve and enlarged right atrium indicating tricuspid stenosis
Ashley Davidoff TheCommonVein.net 124H 135896
Liver Metastases Some Necrotic – 1 Year Prior
12 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows a necrotic mass in the right lobe with multiple other foci of metastasis throughout the liver
Ashley Davidoff TheCommonVein.net 124H 135897
12 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows central necrosis of some of the lesions in the right lobe of the liver with other foci of metastasis throughout the liver
Ashley Davidoff TheCommonVein.net 124H 135898
Diarrhea – Liver Metastases Enlarged IVC Empty Colon
12 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows central necrosis in some of the lesions in the right lobe of the liver with other foci of metastasis throughout the liver No formed stool is seen in the visualised parts of the colon The patient is known to have chronic diarrhea caused by excessive serotonin
Ashley Davidoff TheCommonVein.net 124H 135901
12 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the transverse colon shows no formed stool. The patient is known to have chronic diarrhea caused by excessive serotonin
Ashley Davidoff TheCommonVein.net 124H 135899
Diarrhea – Empty Sigmoid Colon
12 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the sigmoid colon shows no formed stool. The patient is known to have chronic diarrhea caused by excessive serotonin
Ashley Davidoff TheCommonVein.net 124H 135900
Tricuspid Stenosis
4 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart shows thickened tricuspid valve and enlarged right atrium indicating tricuspid stenosis
Ashley Davidoff TheCommonVein.net 124H 135902
Liver Metastases 4 Months Prior
4 Months Prior
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows central necrosis of some of the lesions in the right lobe of the liver with other foci of metastasis throughout the liver
Ashley Davidoff TheCommonVein.net 124H 135903
Tricuspid Stenosis – Current
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart shows thickened tricuspid valve and enlarged right atrium indicating tricuspid stenosis
Ashley Davidoff TheCommonVein.net 124H 135904
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart shows thickened tricuspid valve and enlarged right atrium indicating tricuspid stenosis
Ashley Davidoff TheCommonVein.net 124H 135905
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart shows thickened tricuspid valve and enlarged right atrium indicating tricuspid stenosis
Ashley Davidoff TheCommonVein.net 124H 135906
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart shows thickened tricuspid valve and enlarged right atrium indicating tricuspid stenosis
The dome of the liver with metastases is seen at the right base
Ashley Davidoff TheCommonVein.net 124H 135907
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart in the coronal plane shows thickened tricuspid valve and enlarged right atrium indicating tricuspid stenosis
The dome of the liver with metastases is noted
Ashley Davidoff TheCommonVein.net 124H 135908
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the heart in the sagittal plane shows a thickened tricuspid valve and enlarged right atrium indicating tricuspicd stenosis
The dome of the liver with metastases is noted
Ashley Davidoff TheCommonVein.net 124H 135909
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows central necrosis of some of the lesions in the right lobe of the liver with other foci of metastasis throughout the liver
Ashley Davidoff TheCommonVein.net 124H 135910b
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the liver shows a necrotic mass in the right lobe with multiple other foci of metastasis throughout the liver
Ashley Davidoff TheCommonVein.net 124H 13910a
Diarrhea
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the pelvis shows a fluid filled small bowel and no formed stool in the visualised bowel. he patient is known to have chronic diarrhea caused by excessive serotonin
Ashley Davidoff TheCommonVein.net 124H 135911
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the pelvis shows a fluid filled sigmoid colon and rectum and no formed stool in the visualised. he patient is known to have chronic diarrhea caused by excessive serotonin
Ashley Davidoff TheCommonVein.net 124H 135911
Blastic Bone Metastases
Current
55-year-old male with carcinoid of unknown primary with extensive metastatic disease to liver. CT scan through the lower liver shows a blastic metastasis in L2
Ashley Davidoff TheCommonVein.net 124H 135913