Octreotide Case 3 Answers

1) Any evidence for metastases or recurrence?

There is a small focus in the left lung and a larger focus seen in the midline of the central abdomen. This was seen on CT as a 3cm lesion in the small bowel mesentery, thought to represent a lymph node recurrence

2) Describe the CT findings of carcinoid tumours

These include

A "spoke wheel" pattern or spiculated mesenteric mass is considered pathognomonic for carcinoid tumour.
A discreet tumour mass is visualized in only a minority of cases
Calcification may be detected in one third of these masses
More typically, mesenteric retraction and fibrosis is seen (a desmoplastic reaction) with sharply angulated or buckled bowel loops and bowell wall thickening.
Liver metastases are present in half of cases and the majority of liver lesions are hypervascular

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