A Rare Complication: Aortic Thrombosis Complicating A Carcinoid Syndrome Secondary to Small Bowel Neuroendocrine Tumor: Case report

Abstract

Despite advancements in managing metastatic neuroendocrine tumors (NETs), cardiovascular complications remain a significant cause of morbidity and mortality in patients with carcinoid syndrome. We present a rare case of aortic thrombosis complicating carcinoid syndrome secondary to a small bowel neuroendocrine tumor. A 69-year-old male chronic smoker presented with treatment-resistant diarrhea, febrile sensations, and facial erythema. Imaging revealed a tissue mass in the right iliac fossa, infiltrating the ileocecal angle. Preoperative assessment was unremarkable, and the patient underwent open surgery for right ileocolectomy. Postoperatively, he developed chest pain and dyspnea, with elevated D-dimer levels and a floating aortic thrombus detected on angioscan. Management included unfractionated heparin, vitamin K antagonists, and octreotide. Pathological examination confirmed the neuroendocrine tumor. At 1-year follow-up, the patient showed no cardiovascular anomalies. This case highlights the need for further research on antithrombotic prophylaxis in NETs and underscores the complexity of managing paraneoplastic embolism.