Mid-Gut Carcinoid Tumour Presenting as Suspected Orbital Metastasis

Sultan Qaboos Univ Med J. 2019 Aug;19(3):e253-e256. doi: 10.18295/squmj.2019.19.03.013. Epub 2019 Nov 5.

Abstract

Although metastasis of carcinoid tumours of the intestine is rare, it has been reported in several organs, mainly in the lungs, the liver and less commonly in the orbits. We report a 50-year-old male patient who presented at Hamad General Hospital, Doha, Qatar, in 2016 with central abdominal pain, distention, nausea and vomiting for the previous four days. The patient had unilateral right-sided exophthalmos for two years prior to presentation. Following an abdominal computed tomography (CT) scan and an ultrasound guided biopsy, the patient was diagnosed with extensive multi-focal metastatic carcinoid tumour of the small bowel and mesentery; histopathology confirmed the diagnosis. Subsequently, the patient underwent a laparotomy and small bowel resection and was administered somatostatin therapy. One week postoperatively, the patient developed an acute increase in his right eye exophthalmos. CT, magnetic resonance imaging and scintigraphy scans revealed an orbital metastatic lesion, which probably originated from the previously diagnosed carcinoid tumour. The orbital metastasis was treated with somatostatin therapy and the patient was lost to follow-up when he left the country.

Keywords: Carcinoid Tumor; Case Report; Exophthalmos; Metastasis; Orbital Neoplasm; Qatar; Scintigraphy.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Carcinoid Tumor / diagnostic imaging
  • Carcinoid Tumor / drug therapy
  • Carcinoid Tumor / pathology*
  • Exophthalmos / diagnostic imaging
  • Exophthalmos / pathology*
  • Gastrointestinal Neoplasms / diagnostic imaging
  • Gastrointestinal Neoplasms / drug therapy
  • Gastrointestinal Neoplasms / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nausea
  • Orbit / diagnostic imaging
  • Orbit / pathology*
  • Orbital Neoplasms / diagnostic imaging
  • Orbital Neoplasms / drug therapy
  • Orbital Neoplasms / secondary*
  • Radionuclide Imaging
  • Somatostatin / analogs & derivatives*
  • Somatostatin / therapeutic use
  • Vomiting

Substances

  • Somatostatin