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A cause to consider for chronic unresolving diarrhea.

Hilal T - Gastroenterol Rep (Oxf) (2014)

Bottom Line: A colonoscopy revealed a polypoid lesion in the terminal ileum, which was biopsied, revealing a neuroendocrine tumor (NET).He was treated with palliative octreotide and chemoembolization of liver metastases until disease progression.The case highlights the importance of considering functional NETs, especially carcinoid syndrome, in patients with chronic unresolving diarrhea, since early diagnosis allows for further treatment options that can prolong survival.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA talal.hilal@uky.edu.

No MeSH data available.


Related in: MedlinePlus

(A) Polypoid lesion in the terminal ileum seen on colonoscopy. (B) Hematoxylin and eosin stain of biopsy specimen, showing a well-differentiated neuroendocrine tumor. (C) Immunohistochemistry for chromogranin A and (D) for synaptophysin, confirming diagnosis of a neuroendocrine tumor.
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gou071-F2: (A) Polypoid lesion in the terminal ileum seen on colonoscopy. (B) Hematoxylin and eosin stain of biopsy specimen, showing a well-differentiated neuroendocrine tumor. (C) Immunohistochemistry for chromogranin A and (D) for synaptophysin, confirming diagnosis of a neuroendocrine tumor.

Mentions: Laboratory data were unremarkable, including hemoglobin, liver enzymes, stool analysis and culture, stool ova and parasites and polymerase chain reaction (PCR) for Clostridium difficile in stool sample. Abdominal computed tomography (CT) with intravenous contrast revealed massive hepatomegaly with multiple liver hyperintensities (Figures 1A and 1B), a normal-appearing colon, and no identifiable lymphadenopathy. Due to the metastatic appearance of the liver lesions, the patient was scheduled for a colonoscopy. The procedure did not reveal gross abnormalities in the colon, but terminal ileoscopy showed a small, 2 cm, polypoid lesion in the terminal ileum, which was biopsied (Figure 2A).Figure 1.


A cause to consider for chronic unresolving diarrhea.

Hilal T - Gastroenterol Rep (Oxf) (2014)

(A) Polypoid lesion in the terminal ileum seen on colonoscopy. (B) Hematoxylin and eosin stain of biopsy specimen, showing a well-differentiated neuroendocrine tumor. (C) Immunohistochemistry for chromogranin A and (D) for synaptophysin, confirming diagnosis of a neuroendocrine tumor.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4863180&req=5

gou071-F2: (A) Polypoid lesion in the terminal ileum seen on colonoscopy. (B) Hematoxylin and eosin stain of biopsy specimen, showing a well-differentiated neuroendocrine tumor. (C) Immunohistochemistry for chromogranin A and (D) for synaptophysin, confirming diagnosis of a neuroendocrine tumor.
Mentions: Laboratory data were unremarkable, including hemoglobin, liver enzymes, stool analysis and culture, stool ova and parasites and polymerase chain reaction (PCR) for Clostridium difficile in stool sample. Abdominal computed tomography (CT) with intravenous contrast revealed massive hepatomegaly with multiple liver hyperintensities (Figures 1A and 1B), a normal-appearing colon, and no identifiable lymphadenopathy. Due to the metastatic appearance of the liver lesions, the patient was scheduled for a colonoscopy. The procedure did not reveal gross abnormalities in the colon, but terminal ileoscopy showed a small, 2 cm, polypoid lesion in the terminal ileum, which was biopsied (Figure 2A).Figure 1.

Bottom Line: A colonoscopy revealed a polypoid lesion in the terminal ileum, which was biopsied, revealing a neuroendocrine tumor (NET).He was treated with palliative octreotide and chemoembolization of liver metastases until disease progression.The case highlights the importance of considering functional NETs, especially carcinoid syndrome, in patients with chronic unresolving diarrhea, since early diagnosis allows for further treatment options that can prolong survival.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA talal.hilal@uky.edu.

No MeSH data available.


Related in: MedlinePlus