Carcinoid syndrome CT

Chest CT scan may be helpful in the diagnosis of carcinoid tumor. On high-resolution CT scan of the chest, peripheral pulmonary carcinoid tumor is characterized by a solitary and round pulmonary nodule with a lobulated margin, whereas bronchial carcinoid tumor is characterized by a single well-defined, round or ovoid, hilar or perihilar mass with marked homogenous enhancement. On CT scan of the neck, thymic carcinoid tumor is characterized by a mass with heterogeneous attenuation.

• CT is poor in detecting primary carcinoid tumor but helpful in evaluating the extent of tumour spread before surgical exploration.^[1]
• Most common finding is liver metastases.
• Mesenteric metastases and retroperitoneal adenopathy can also be detected.
• Carcinoid tumor that have infiltrated the mesentery have a characteristic CT appearance as a ill-defined mesenteric mass containing calcification in up to 70% of cases.^[2]
• Three-dimensional CT angiography detects mesenteric mass and its relationship to the vessels which is important for surgical planning.

Findings on high-resolution CT scan suggestive of peripheral pulmonary carcinoid tumor include:^[3]

• Discovered as an incidental solitary and round pulmonary nodule
• Size at diagnosis can vary but ranges between 10-30 mm
• Lobulated margin

Findings on high-resolution CT scan suggestive of bronchial carcinoid tumor include:^[4][5]

• Well-defined single hilar or perihilar mass
• Round or ovoid in shape
• Variable in size but typically ranges between 2-5 cm
• Marked homogeneous contrast enhancement due to high vascularity
• Calcification (usually eccentric) can occur

Findings on neck CT scan suggestive of thymic carcinoid tumor include:^[6]

• Mass with heterogeneous attenuation

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