Clinical and Endoscopic Characters of a Young Female with Colonic Carcinoid Syndrome: A Case Report in Yemen

Neuroendocrine tumors are the proliferation of neuroendocrine cells that are known to be highly aggressive with a high mortality rate. Most of them are seen within the small intestine and rectum, but rarely within the Large intestinal. The clinical presentations vary from asymptomatic incidentally discovered lesions to lethal metastatic disease with carcinoid syndrome. In our case, a 25 year-old-lady presented with acute abdominal pain, frequent attacks of diarrhea, nausea, vomiting, and brief attacks of facial flushing with significant weight loss for 2 months. Work-up of the patient led to the diagnosis of many colonic sub-epithelial lesions involving the cecum, ascending, and transverse colon, a highly unlikely location, with multiple small hepatic nodules. Twenty-four hours urinary 5-HIAA confirms the diagnosis of carcinoid syndrome. Early-stage tumors have a good prognosis with an 85% overall 5-year survival rate but a poor prognosis in late-stage carcinoid syndrome. Therefore, routine colonoscopic examinations should be performed for early diagnosis and management.