A 17-year-old male with a Small Bowel Neuroendocrine Tumor: flushing differential diagnosis View Full Text


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Article Info

DATE

2017-09-04

AUTHORS

Maria Alejandra Forero Molina, Elizabeth Garcia, Deyanira Gonzalez-Devia, Rafael García-Duperly, Alonso Vera

ABSTRACT

BackgroundNeuroendocrine tumors (NETs) are heterogeneous neoplasms that originate from cells with a secretory function. Small bowel NETs (SB-NETs) are related to serotonin hypersecretion which causes: flushing, diarrhea, abdominal pain, bronchoconstriction and heart involvement, also known as carcinoid syndrome (CS). CS can be confused with an allergic reaction and thus should be considered as a differential diagnosis in the allergy consult. We present the case of a pediatric patient initially referred under the suspicion of food allergies.Case presentationWe present the case of a 17-year-old male with evanescent non-pruriginous erythematous lesions- flushing that appeared with food consumption, associated with conjunctival injection, warmth and diaphoresis after the lesions disappeared. He denied abdominal pain, diarrhea, cough or wheezing. The 24-h urinary 5-hydroxyindoleacetic acid (5-HIAA) excretion was elevated. The CT scan showed thickening of the distal ileum and multiple lesions on both hepatic lobules and the colonoscopy revealed a tumor in the ileocecal valve. Hepatic and intestinal biopsies reported a well-differentiated NET of the ileocecal valve with hepatic metastasis. He was started on octreotide and underwent a wide hepatectomy and right hemicolectomy with improvement of symptoms.ConclusionsNETs can present as carcinoid syndrome (flushing, diarrhea, abdominal pain, wheezing), which constitutes vague symptomatology and represents a challenging diagnosis for physicians. They can be confused with an allergic reaction and the allergist should consider it as a differential diagnosis. Accurate diagnostic tests will help to diagnose NETs earlier and potentially prevent carcinoid heart disease, bowel obstruction, and improve quality of life and mortality in these patients. More... »

PAGES

30

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URI

http://scigraph.springernature.com/pub.10.1186/s40413-017-0161-4

DOI

http://dx.doi.org/10.1186/s40413-017-0161-4

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https://app.dimensions.ai/details/publication/pub.1091018141

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28904734


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