eMedicine Specialties > Radiology > Gastrointestinal
Carcinoid, Gastrointestinal: Imaging
Updated: Apr 2, 2008
Radiography
Findings
Characteristic appearance of small-bowel carcinoid. Plain abdominal radiograph in a 55-year-old man presenting with clinical features of bowel obstruction (same patient as in Images 2-5 in Multimedia). Small-bowel dilatation is confined to the upper abdomen. Speckled calcification is noted in a small, circular mass to the right of the mid lumbar spine.
Characteristic appearance of small bowel carcinoid. Barium enema in a 55-year-old man presenting with clinical features of bowel obstruction (same patient as in Images 1 and 3-5 in Multimedia). Barium enema study shows no obstructive lesion within the large bowel, but the cecum demonstrates an extrinsic impression on its medial side (arrow).
Characteristic appearance of small bowel carcinoid in a 55-year-old man presenting with clinical features of bowel obstruction (same patient as in Images 1-2 and 4-5 in Multimedia). Upper gastrointestinal barium series shows a smooth submucosal mass in the mid jejunum eccentrically placed and associated with thickened valvulae conniventes resulting from bowel edema and proximal small-bowel dilatation. Note the angulation of the bowel and kinking of the jejunum at the site of the submucosal mass.
Single-contrast-phase image of a barium enema study shows an eccentric narrowing of the splenic flexure associated with paucity of gas in the right hypochondrium resulting from a probable soft-tissue mass (see also Image 9 in Multimedia).
Characteristic angiographic appearance of a carcinoid mesenteric invasion. Arterial/early capillary phase of a superior mesenteric angiogram (same patient as in Image 8 in Multimedia) shows the typical radiating configuration of the branches with tortuous peripheral vessels (curved arrows) in the region of the splenic flexure mass. Note the edge of the mesenteric mass (arrowheads) and arterial encasement (straight arrow).
- Biliary carcinoid - Cholangiography shows a polypoid filling defect within the biliary tree or an infiltrating form in which duct stenosis is demonstrated.
- Colon carcinoid
- On barium examination, radiologic features are similar to those of adenocarcinoma and include a filling defect within the colon caused by a sessile polyp, circumferential narrowing (apple-core lesion) associated with mucosal destruction, loss of mucosal folds, and ulceration.
- Imaging findings in a malignant carcinoid depend on its size, the degree of mesenteric invasion/desmoplastic reaction, and the presence of regional lymph node invasion.
- Bowel loops in the right iliac fossa separate and external compression, asymmetric spiculated contour, and kinking of adjacent bowel are demonstrated.
- The carcinoid tumor may not be visible because it is usually buried in the adjacent mass.
- A large-bowel barium series may show compression or infiltration of the cecum at the base of the appendix.
- Duodenal carcinoid - On barium series, tumors appear as intraluminal polypoid lesions or infiltrating lesions that cause an irregular stricture.
- Gastric carcinoid
- Imaging findings are nonspecific and depend on the type of tumor. On barium meal examination, the most common finding is a single, intramural, sharply demarcated defect that is usually 2-3 cm in diameter.
- Tumors may be located anywhere in the stomach, although a fundal location is said to be rare.
- Features may mimic leiomyoma/leiomyosarcoma.
- Tumors may be ulcerated.
- Less commonly, tumors may appear as a large ulcer or polypoid mass.
- In type I disease, multiple sessile polypoid lesions of varying sizes may be seen arising from the wall of the stomach.
- Atypical carcinoids may occur in which histology demonstrates a combination of carcinoid and adenocarcinoma. Atypical tumors have a tendency to ulcerate and show more aggressive behavior, with local tumor spread and lymph node metastasis. The prognosis in patients with atypical tumors usually is poor.
- A bull's-eye, or target, lesion may be seen. This appears as an ulcer on the apex of a nodule on barium meal examination. When a target lesion is noted, the differential diagnosis includes gastric metastases (melanoma, lymphoma, carcinoma-breast, bronchus, pancreas), leiomyoma, pancreatic rest, and gastric neurofibroma.
- Esophageal carcinoid - Tumors may present as intraluminal, extramucosal filling defects on barium studies.
- Pancreatic carcinoid - Plain radiographs may show curvilinear calcification in the region of the pancreatic bed.
- Rectal carcinoid - Tumors are indistinguishable from the more common adenomatous polyps on barium enema. Polyps may be ulcerated. Endorectal ultrasonography and endorectal magnetic resonance imaging (MRI) better demonstrate perirectal infiltration.
- Small-bowel carcinoid
- Plain abdominal radiographs may reveal curvilinear calcification within the abdomen. These are usually smaller than 15 mm in diameter and result from calcification within the tumor.
- On barium studies, findings consist of fairly well-defined, round, intraluminal bowel-filling defects. These may be associated with thickening of the valvulae conniventes resulting from interference of the bowel blood supply by the tumor.
- With invasion of the mesentery, the mesenteric mass causes rigidity, displacement/stretching, and fixation of small-bowel loops. Desmoplastic reaction from mesenteric invasion causes sharp angulation of a bowel loop or a stellate or spokelike wheel arrangement of adjacent bowel loops.
- The tumor often infiltrates the mesentery, provoking an intense fibrotic reaction that results in kinking of the bowel segments; such kinking may in turn cause intestinal obstruction.
- On a small-bowel barium series, kinking of the small-bowel loops is considered the hallmark of a small-bowel carcinoid tumor.
Degree of Confidence
Plain radiographic findings in gastrointestinal carcinoid are nonspecific and may simply reflect bowel obstruction. The calcification occasionally seen in a pancreatic or bowel carcinoid is nonspecific and has many differential diagnoses; however, kinking of the small bowel on a barium series is considered the hallmark of a small-bowel carcinoid.
False Positives/Negatives
Any cause of intestinal obstruction may mimic obstruction resulting from a carcinoid; moreover, on barium series, an intraluminal filling defect found at any location within the bowel, whether benign or malignant, may appear similar to a gastrointestinal carcinoid.
Computed Tomography
Findings
Characteristic appearance of mesenteric desmoplastic reaction from a carcinoid. Axial CT scan through the mid abdomen shows a mesenteric mass (long arrow) with shaggy borders and probable intratumoral punctate calcification (short arrow).
Characteristic appearance of mesenteric desmoplastic reaction from a carcinoid. A 10-mm lower CT section shows stellate radiating and beaded mesenteric neurovascular bundles of the mesentery (arrows) associated with kinking (K) of the small bowel.
Characteristic appearance of carcinoid liver metastases. Contrast-enhanced axial CT scan through the upper abdomen shows early arterial enhancement of the liver metastases (see Image 13 in Multimedia for the portal venous phase).
Characteristic appearance of carcinoid liver metastases. Contrast-enhanced axial CT scan through the upper abdomen shows portal venous phase. The metastases appear as negative defects against the normally enhancing liver (see Image 12 in Multimedia for the hepatic arterial phase).
Appearance of pancreatic carcinoid. Nonenhanced CT scan through the upper abdomen shows a 9-cm mass in the region of the tail of the pancreas with intratumoral pancreatic calcification and multiple mass lesions within the liver, suggestive of metastases (same patient as in Images 23-25 in Multimedia).
Appearance of pancreatic carcinoid. Dynamic contrast-enhanced CT scan in the delayed portal venous phase shows enhancement of the pancreatic tail tumor (arrow) with central necrosis (same patient as in Images 22 and 24-25 in Multimedia).
- Biliary carcinoid - CT scans may demonstrate intrahepatic biliary dilatation associated with an intraductal mass of varying attenuation in the common bile duct. A Klatskin-type tumor representing biliary carcinoid has been reported.
- Colon carcinoid - The frequent presence of an extraluminal component can be delineated better on CT scans. Generally, CT scanning is used to stage colon tumors but not to detect them. CT scan findings of colon carcinoids appear similar to those of adenocarcinoma. The tumor may be visualized as a discrete mass or as focal wall thickening.
- Gastric carcinoid - CT scanning may demonstrate thickening of the stomach wall by nodular masses. A large polypoid mass has been reported arising from the lesser curve of the stomach, with areas of low density that were presumed to represent necrosis.
- Hepatic carcinoid - Often multiple, these tumors are hypo-attenuating on nonenhanced CT scans and are strongly enhancing on contrast-enhanced CT scans. Cystic degeneration may occur. Calcification within carcinoid metastases is not unusual.
- Esophageal carcinoid - CT scanning should be able to demonstrate extraluminal extension and metastases.
- Pancreatic carcinoid - Ultrasonographic and CT scan findings from these carcinoids are indistinguishable from those of islet cell tumors, but calcification is a clue to the diagnosis. CT scans may show a low-attenuation mass associated with calcification in the pancreas. CT scanning and ultrasonography may demonstrate lymph node and liver metastases.
- Small-bowel carcinoid - CT scanning reveals a mass with soft-tissue attenuation and variable size, with spiculated borders and radiating surrounding strands. Calcification may be noted in the tumor. Linear strands within the mesenteric fat probably are thickened and retracted vascular bundles and represent peritumoral desmoplastic reaction. Lymphadenopathy and liver metastases may be visualized on CT scans. Helical CT enteroclysis has been used to detect small-bowel carcinoids and has been found to be more sensitive than are conventional barium studies.8
Degree of Confidence
When CT scanning reveals a solid mass with spiculated borders and radiating surrounding strands that is associated with linear strands within the mesenteric fat and kinking of the bowel, a diagnosis of gastrointestinal carcinoid can be made fairly confidently. Hypervascular enhancing liver metastases in the setting of a high index of clinical suspicion can also be a clue to the diagnosis.9
False Positives/Negatives
Liver and lymph node metastases from an intraluminal bowel mass with mesenteric invasion can mimic carcinoids.
Magnetic Resonance Imaging
Findings
Characteristic appearance of carcinoid liver metastases. Gadolinium-enhanced axial MRI through the liver shows early arterial enhancement of multiple liver tumors (see Image 15 in Multimedia for the portal venous phase).
Characteristic appearance of carcinoid liver metastases. Gadolinium-enhanced axial MRI through the liver shows portal venous phase enhancement of multiple liver tumors (see Image 15 in Multimedia for the hepatic arterial phase).
Generally, MRI is not used in the diagnosis of gastrointestinal carcinoids. Liver metastases are demonstrated well on MRIs and usually have low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. After the administration of a gadolinium-based contrast agent, liver metastases enhance peripherally in the hepatic arterial phase and appear as hypo-intense defects against the enhancing normal liver in the portal venous phase.
MRI demonstrates biliary carcinoids as being hyperintense relative to the liver on T2-weighted images and hypo-intense relative to the liver on T1-weighted images.
Gadolinium-based contrast agents (gadopentetate dimeglumine [Magnevist], gadobenate dimeglumine [MultiHance], gadodiamide [Omniscan], gadoversetamide [OptiMARK], gadoteridol [ProHance]) have recently been linked to the development of nephrogenic systemic fibrosis (NSF) or nephrogenic fibrosing dermopathy (NFD). For more information, see the eMedicine topic Nephrogenic Fibrosing Dermopathy.
The disease has occurred in patients with moderate to end-stage renal disease after being given a gadolinium-based contrast agent to enhance MRI or magnetic resonance angiography (MRA) scans. As of late December 2006, the Food and Drug Administration (FDA) had received reports of 90 such cases. Worldwide, over 200 cases have been reported, according to the FDA. NSF/NFD is a debilitating and sometimes fatal disease. Characteristics include red or dark patches on the skin; burning, itching, swelling, hardening, and tightening of the skin; yellow spots on the whites of the eyes; joint stiffness with trouble moving or straightening the arms, hands, legs, or feet; pain deep in the hip bones or ribs; and muscle weakness. For more information, see the FDA Public Health Advisory or Medscape.
Degree of Confidence
Sufficient experience has not been gained in the use of MRI to provide an assessment of the degree of confidence.
False Positives/Negatives
Any hypervascular liver metastases can appear similar on MRIs.
Ultrasonography
Findings
Characteristic appearance of carcinoid liver metastases with different imaging modalities. Axial sonogram through the liver shows multiple fairly well-defined echogenic liver metastases of varying sizes (see Image 11 in Multimedia for a right-sided image).
Characteristic appearance of carcinoid liver metastases with different imaging modalities. Axial sonogram through the liver shows multiple fairly well-defined echogenic liver metastases of varying sizes (see Image 10 in Multimedia for a left-sided image).
- Biliary carcinoid - Ultrasonography shows evidence of biliary tree dilatation associated with an intraluminal hypo-echoic or hyperechoic mass.
- Appendiceal carcinoid - A persistent fluid-filled, distended appendix without typical signs of appendicitis has been reported with a carcinoid of the appendix.
- Gastric carcinoid - One study using high-resolution transabdominal ultrasonography showed a hypo-echoic mass lesion arising from the muscular layer of the stomach.10
- Hepatic carcinoid - On ultrasonography, liver metastases vary from hypo-echoic to hyperechoic and show strong enhancement with intravenous contrast media. Tumors demonstrate peripheral hypervascularity on color and power Doppler images.
- Pancreatic carcinoid - Ultrasonographic and CT scan appearances are indistinguishable from those of islet cell tumors, but calcification is a clue to the diagnosis. Ultrasonographic findings usually demonstrate a hypo-echoic mass, which may be of varying size but tends to be small. Ultrasonography may demonstrate lymph node and liver metastases.
- Rectal carcinoid - Perirectal infiltration is better demonstrated on endorectal ultrasonography and endorectal MRI.
- Small-bowel carcinoid - Ultrasonography of the bowel can depict bowel tumors, with a pseudokidney sign. Associated lymphadenopathy and liver metastases may be demonstrated on ultrasonograms.
Degree of Confidence
On ultrasonograms, carcinoid findings are too nonspecific to offer a confident diagnosis.
False Positives/Negatives
Any bowel mass or hypervascular liver metastases can result in similar findings.
Nuclear Imaging
Findings
Characteristic appearance of small bowel carcinoid in a 55-year-old man presenting with clinical features of bowel obstruction (same patient as in Images 1-3 and 5 in Multimedia). Images from an indium-111 octreotide scintigraphic study (at 44 h) show the primary lesion (straight arrow, top left image), mesenteric metastases (curved open arrow, top left image), liver metastases (arrows, top right image), and a rib metastatic deposit (arrow, bottom right image); this was confirmed on postmortem study. Bladder activity, which is a normal phenomenon, is marked by a curved solid arrow (top left image).
Characteristic appearance of small bowel carcinoid in a 55-year-old man presenting with clinical features of bowel obstruction (same patient as in Images 1-4 in Multimedia). Images from an indium-111 octreotide scintigraphic study (at 68 h) show the primary lesion (straight arrow, top left image), mesenteric metastases (curved, open arrow; top left image), liver metastases (arrows, top right image), and a rib metastatic deposit (arrowhead, bottom right image); this was confirmed on postmortem study. Bladder activity, which is a normal phenomenon, is marked by a curved, solid arrow (top left image).
Characteristic appearance of carcinoid liver metastases. Planar indium-111 octreotide scan shows the primary lesion (solid straight arrow), mesenteric metastases (open straight arrows), and multiple liver metastases. Bladder activity is indicated by a curved arrow (see also Image 17 in Multimedia).
Characteristic appearance of carcinoid liver metastases. Planar indium-111 octreotide scan shows the primary lesion, mesenteric metastases, and multiple liver metastases. Bladder activity is indicated by a curved arrow (see also Image 16 in Multimedia).
Characteristic appearance of carcinoid liver metastases. Single-photon emission CT scan obtained with indium-111 octreotide shows liver lesions in detail (see also Image 19 in Multimedia).
Characteristic appearance of carcinoid liver metastases. Single-photon emission CT scan obtained with indium-111 octreotide shows the liver lesions in detail (see also Image 18 in Multimedia).
- Gastric carcinoid - Scintigraphy performed with a somatostatin receptor analogue may prove useful in the treatment of patients with hypergastrinemic states who have increased incidence of gastric carcinoids. In patients with MEN-1, localization in the upper abdomen may not be associated with a pancreatic endocrine tumor but rather with a gastric carcinoid.
- Pancreatic carcinoid - Somatostatin-analogue scintigraphy has been proven sensitive. However, the findings are nonspecific, because the study may also show positive findings for islet cell tumors.
- Small bowel carcinoid
- Somatostatin-receptor scintigraphy performed with indium-111 (111 In) octreotide and111 In pentetreotide is used to image many neuro-endocrine tumors, including carcinoids with somatostatin-binding sites.6 Several studies have shown that somatostatin-receptor scintigraphy is a sensitive and noninvasive technique for imaging primary carcinoid tumors and carcinoid metastatic spread. A refinement of the technique that increases sensitivity is the addition of single photon emission CT (SPECT) scanning.
- Scintigraphy performed with iodine-123 (123 I) meta-iodobenzylguanidine demonstrates a 44-63% uptake in gastrointestinal carcinoids.11 A higher frequency of radionuclide uptake is found in midgut carcinoids and tumors with elevated serotonin levels.
- [Fluorine-18]fluorodopa positron emission tomography (18 F-dopa – PET) scanning has been used to image primary gastrointestinal carcinoid tumors and lymph node and organ metastases with promising results.12,13
PET scanning with fluorodeoxyglucose (FDG) is now more available and more widely used. In general, FDG-PET scanning is useful in poorly differentiated carcinoids and other neuro-endocrine tumors, but it should not be used as a first-line imaging agent. FDG-PET scanning is primarily useful when the results of somatostatin-receptor scintigraphy are negative.14
Degree of Confidence
More than 90% of gastrointestinal carcinoids and their metastases are identified using somatostatin receptor scintigraphy, and accumulation is often seen in clinically unsuspected sites not recognized using other imaging techniques.18 F-dopa – PET scanning is a promising procedure that is a useful supplement to morphologic imaging methods. FDG-PET imaging is useful in poorly differentiated carcinoids when the results of somatostatin-receptor scintigraphy are negative.
False Positives/Negatives
Somatostatin-receptor scintigraphy is not specific for carcinoids. Uptake occurs in other lesions with a high density of somatostatin receptors; these include the following:
- Gastrinomas
- Glucagonomas
- Somatostatinomas
- Vaso-active intestinal polypeptide tumors
- Neural crest tumors (eg, paragangliomas, medullary thyroid carcinomas, neuroblastomas, pheochromocytomas)
- Oat cell lung carcinomas
- Lymphoproliferative disease (eg, Hodgkin lymphoma, non-Hodgkin lymphoma)
Angiography
Findings
Characteristic appearance of carcinoid liver metastases. Celiac-axis angiogram shows early enhancement of the liver metastases in the arterial phase (see Image 21 in Multimedia for the capillary phase).
Characteristic appearance of carcinoid liver metastases. Celiac-axis angiogram shows persisting enhancement of the liver metastases in the capillary phase (see Image 20 in Multimedia for the arterial phase).
Appearance of pancreatic carcinoid. Right hepatic angiogram shows early enhancement of multiple liver tumors (same patient as in Images 22-23 and 25 in Multimedia).
Appearance of pancreatic carcinoid. Left hepatic angiogram late capillary/early venous phase shows a large, left-lobe tumor with arteriovenous shunting (curved arrow). The pancreatic tumor also derives its blood supply from the left hepatic arterial circulation (straight arrows) (same patient as in Images 22-24 in Multimedia).
Before the advent of cross-sectional imaging, mesenteric angiography provided useful information regarding characterization of small-bowel carcinoids. The angiographic appearances of small-bowel carcinoids encountered on angiograms produced for other indications, such as gastrointestinal bleeding, are worth noting. Foreshortening of the bowel occurring with desmoplastic reaction makes mesenteric arteries tortuous and frequently narrowed; it also draws the arteries into a stellate pattern. The areas involved appear hypervascular, but in reality, the number of arteries in the area does not increase. Instead, the arteries contract into a smaller area as a result of fibrosis.15
An additional arterial change associated with carcinoids is smooth, multifocal stenosis of the mesenteric arteries distant from the tumor. Tumors seldom show capillary blush or demonstrate early or dense venous drainage. Venous occlusion and mesenteric varices also have been reported. These findings are nonspecific and have been reported with sclerosing peritonitis and with a carcinoma of the pancreas invading the mesentery. Selective hepatic angiography can demonstrate hypervascular liver metastases by demonstrating capillary blush in involved areas, highlighting the potential response of tumors to embolization.16
Degree of Confidence
Foreshortening of the bowel occurring with desmoplastic reaction makes mesenteric arteries tortuous and frequently narrowed, in addition to drawing the arteries into a stellate pattern. Involved areas appear hypervascular, but in reality, the number of arteries in the area does not increase; instead, arteries contract into a smaller area because of fibrosis. With a high index of clinical suspicion, the degree of confidence in diagnosing gastrointestinal carcinoid is high when these findings are seen in combination with the other imaging features described.
False Positives/Negatives
Findings are nonspecific and have been reported with sclerosing peritonitis, desmoid tumors, and a carcinoma of the pancreas invading the mesentery.
More on Carcinoid, Gastrointestinal |
| Overview: Carcinoid, Gastrointestinal |
 Imaging: Carcinoid, Gastrointestinal |
| Follow-up: Carcinoid, Gastrointestinal |
| Multimedia: Carcinoid, Gastrointestinal |
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References
Binstock AJ, Johnson CD, Stephens DH, et al. Carcinoid tumors of the stomach: a clinical and radiographic study. AJR Am J Roentgenol. Apr 2001;176(4):947-51. [Medline]. [Full Text].
Berger MW, Stephens DH. Gastric carcinoid tumors associated with chronic hypergastrinemia in a patient with Zollinger-Ellison syndrome. Radiology. Nov 1996;201(2):371-3. [Medline]. [Full Text].
Ho AC, Horton KM, Fishman EK. Gastric carcinoid tumors as a consequence of chronic hypergastrinemia: spiral CT findings. Clin Imaging. Jul-Aug 2000;24(4):200-3. [Medline].
Ready AR, Soul JO, Newman J, et al. Malignant carcinoid tumour of the oesophagus. Thorax. Jul 1989;44(7):594-6. [Medline].
Gibril F, Reynolds JC, Lubensky IA, et al. Ability of somatostatin receptor scintigraphy to identify patients with gastric carcinoids: a prospective study. J Nucl Med. Oct 2000;41(10):1646-56. [Medline].
Kimura T, Sakahara H, Higashi T, et al. [Imaging of somatostatin receptor using 111In-pentetreotide]. Kaku Igaku. Apr 1996;33(4):447-52. [Medline].
Kwekkeboom DJ, Lamberts SW, Habbema JD, et al. Cost-effectiveness analysis of somatostatin receptor scintigraphy. J Nucl Med. Jun 1996;37(6):886-92. [Medline]. [Full Text].
Orjollet-Lecoanet C, Menard Y, Martins A, et al. [CT enteroclysis for detection of small bowel tumors]. J Radiol. Jun 2000;81(6):618-27. [Medline]. [Full Text].
Fruauff A, Irwin GA, Williams HC, et al. CT demonstration of gastric carcinoid. AJR Am J Roentgenol. Jun 1987;148(6):1276-7. [Medline].
Tsai TL, Changchien CS, Hu TH, et al. Demonstration of gastric submucosal lesions by high-resolution transabdominal sonography. J Clin Ultrasound. Mar 2000;28(3):125-32. [Medline].
Adolph JM, Kimmig BN, Georgi P, et al. Carcinoid tumors: CT and I-131 meta-iodo-benzylguanidine scintigraphy. Radiology. Jul 1987;164(1):199-203. [Medline]. [Full Text].
Hoegerle S, Altehoefer C, Ghanem N. Whole-body 18F dopa PET for detection of gastrointestinal carcinoid tumors. Radiology. Aug 2001;220(2):373-80. [Medline]. [Full Text].
Koopmans KP, Neels OC, Kema IP, et al. Improved staging of patients with carcinoid and islet cell tumors with 18F-dihydroxy-phenyl-alanine and 11C-5-hydroxy-tryptophan positron emission tomography. J Clin Oncol. Mar 20 2008;26(9):1489-95. [Medline].
Adams S, Baum R, Rink T. Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumours. Eur J Nucl Med. Jan 1998;25(1):79-83. [Medline].
Bousen E, Reuter SR. Mesenteric angiography in the evaluation of inflammatory and neoplastic disease of the intestine. Radiology. Dec 1966;87(6):1028-36. [Medline].
Sharma KV, Gould JE, Harbour JW, et al. Hepatic arterial chemoembolization for management of metastatic melanoma. AJR Am J Roentgenol. Jan 2008;190(1):99-104. [Medline].
Mukherjee E, Mukherji D, Jayawardene SA, et al. Tumor lysis syndrome and acute renal failure--an increasing spectrum of presentations. Clin Nephrol. Sep 2007;68(3):186-9. [Medline].
Eriksson J, Stålberg P, Nilsson A, et al. Surgery and radiofrequency ablation for treatment of liver metastases from midgut and foregut carcinoids and endocrine pancreatic tumors. World J Surg. Mar 7 2008;[Medline].
Campana D, Nori F, Pezzilli R, et al. Gastric endocrine tumors type I: treatment with long-acting somatostatin analogs. Endocr Relat Cancer. Mar 2008;15(1):337-42. [Medline].
Further Reading
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Carcinoid Tumor
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Lung, Carcinoid
Keywords
gastrointestinal carcinoid, GI carcinoid, gastrointestinal tumor, GI tumor, argentaffin tumors, argentaffinoma, enterochromaffin cells of Kulchitsky, carcinoid syndrome
