The carcinoid syndrome is a rare clinical entity, coursing with a slow evolution. Patients typically present flush, diarrhea and acute asthma attacks, which often delays the diagnostic until there is cardiac involvement, with more pronounced symptoms. We report the clinical case of a 62 years-old male, with a known significant tricuspid valve disorder. While waiting for cardiac surgery, he presented with an acute abdominal condition, which allowed the detection of a carcinoid syndrome. He underwent surgical excision of the primary tumor (right hemicolectomy), removal of hepatic metastases, and tricuspid valve replacement.