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An atypical cause of nausea

Ilie Madalina, Turculet C., Diaconu Camelia, Tincu R., Constantinescu G., Stanciulescu Luminita, Macovei R., Enache V., Popa B., Ene D.
Abstract: Even if, ileal carcinoid tumours have a low incidence (0.2-0.8/100000), the diagnosis must be considered in the presence of hepatic metastasis of unknown origin. We report a case of 55 years old female that presents persistent nausea, for one year prior to admission. She was suspected of gallbladder stones and an abdominal ultrasound was performed. The result was normal and the patient presented to our clinic for a routine check-up. At the repeated ultrasound we found multiple focal hyperechoic liver lesions of maximum 10 mm. She was referred immediately for a CT-scan with intravenous contrast but the result was surprisingly normal. We insisted in our investigation and the patient was sent for a total abdominal MRI. The result revealed ileal tumour of 2 cm with liver metastases. Palliative surgery with resection of ileal tumour and liver metastasis biopsy is performed. The pathology result was compatible with neuroendocrine tumor G1(Ki 67 index 1-2%) with liver metastasis.

Keywords: neuroendocrine tumor, liver metastasis, nausea, Ki 67 index


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