Pediatric Carcinoid Tumor

  • Etiology: Derived from enterochromaffin cells – not present under the age of 4 years
  • Imaging:
    — Most common sites – ileum and appendix
    — Enhancing soft tissue mass or bowel wall thickening with or without mesenteric fibrosis
    — Gallium-68 octreotide PET-CT versus indium-111 pentetreotide SPECT-CT versus indium-111 octreotide SPECT-CT versus iodine-123 MIBG
  • Note: Appendiceal carcinoid presents like acute appendicitis but is rarely visible preoperatively
  • DDX:
  • Complications: Ileal and cecal carcinoids commonly metastasize
  • Treatment:
  • Clinical:
    — Carcinoid syndrome if spread to the liver or beyond
    — Elevated levels of urinary 5-hydroxyindoleacetic acid (5-HIAA)

Radiology Cases of Carcinoid Tumor

Radiology Cases of Carcinoid Tumor of the Lung

CXR of carcinoid tumor of the chest
CXR AP and lateral show a dense consolidation in the right middle lobe.

Radiology Cases of Carcinoid Tumor of the Appendix and Acute Appendicitis

CT of carcinoid tumor of the appendix
Axial CT with contrast of the abdomen (above) shows on top of the right psoas muscle and right iliac vessels in the right lower quadrant a dilated, fluid-filled tubular structure containing a calcification . Coronal CT (below) shows two calcifications within the tubular structure which is just medial to the cecum and surrounded by inflammatory changes.

CT of pediatric carcinoid tumor of appendix.
Coronal CT MIP with contrast of the abdomen (left) shows a dilated appendix arising from the medial wall of the cecum which is seen to have 3 appendicoliths at its tip (right). There is minimal periappendiceal inflammation.