Carcinoid

Radiological

Because signs and symptoms are often absent or nonspecific early in the disease course), imaging plays an important role is disease identification. Early (before muscular invasion and desmoplastic metastases) manifestation is that of a solitary polypoid nodule projecting into the bowel lumen, or less frequently, multiple nodules.

Because of its sensitivity in evaluating the mucosal surface, fluoroscopy is optimal for demonstrating small carcinoid tumors. Fluoroscopically, these nodules are seen as smooth, rounded luminal filling defects. As the mass enlarges, hemorrhage and necrosis can occur.  If growth occurs into bowel lumen (endoenteric), this can result in ulceration or obstruction. Rarely, carcinoid can be the lead-point in intussusception. If growth occurs into the soft tissues adjacent to the bowel wall (exoenteric growth), it can cause separation and tethering of bowel loops and a desmoplastic (fibrotic) reaction.

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