Endocrine Abstracts

Background: Carcinoid tumors are rare and slow growing malignancies derived from enterochromaffin cells. Two-thirds of carcinoid tumors arise in the gastrointestinal tract, and in 3% of these cases the primary site cannot be determined. Presenting symptoms depend on the location of the primary tumor may be nonspecific and in 13% of patients distant metastases are discovered on diagnosis.

Case presentation: A 64 years old woman was admitted for diffuse abdominal pain, especially in the epigastric, upper right quadrant and unintentional weight loss (10 kg in the last 5 months), being known with 19 years evolution of well differentiated neuroendocrine carcinoma (Ki 67=1%), with no identifiable primary and metastases since 2000: mesenteric, peritoneal, bladder, ovary treated by surgical removal (70 cm of intestinal resection and total hysterectomy with bilateral anexectomy) followed up by chemotherapy. Current therapy: Sandostatin LAR 40 mg/28 days (since 2012). Paraclinic evaluation: high serum serotonin values (3xULN), IRM scan showed multiple different nodular hepatic images (maximum 5 cm) followed by the GI endoscopy with gastric tumor findings.

Conclusions: This is a case of a patient who developed invasive gastric tumor after long term evolution of a multiple metastatic neuroendocrine carcinoma of unknown primary site. Despite symptomatic treatment, pointing to a reserved prognosis, the patient has had a long stable evolution of the disease.