Carcinoid Tumor of the Ileum Resembling Regional Ileitis Clinically and Roentgenologically

Although the first descriptions of what apparently were carcinoid tumors appeared in the literature in the late 19th century, it was not until recently that a connection was made between this tumor and a metabolic disorder.l, 2 Despite the numerous reports of malignant carcinoid tumors, only a small numher of these have produced the true metabolic disorder known as carcinoid syndrome. MacDonald,3 in his 1956 report, remarks that up until the time of publication of the paper only 57 cases of acceptable carcinoid syndrome had been found in a review of the literature. Since then much attention has been focused on this syndrome, with various authors stressing the different sites of the primary tumor. Spain noted that "the carcinoid tumor or argentaffinoma may occur at any point within the gastrointestinal tract, from the cardiac end of the stomach to the anus. It is frequently observed in the appendix and ileum, occasionally in a Meckel's diverticulum or the gall bladder, and rarely in teratomas of the ovaries and testis." Hines et aZ." believe that the rectum is the most common extraappendiceal site of carcinoids, although they are somewhat at variance with most other authors, who state that the ileum is the most frequent extra-appendiceal site. The following report represents a case of carcinoid tumor which evidently was associated with an incomplete carcinoid syndrome. Because of the similarity in the clinical syndrome and particularly the x-ray findings, it was the erroneous impression for approximately 8 years prior to his death that this patient had regional ileitis.