Abstract
Case Presentation: A 66-year-old male presented with ileal carcinoid. A month before, he had undergone a screening colonoscopy, which identified a 1-cm nodule in the terminal ileum. Biopsy showed low-grade, well-differentiated neuroendocrine tumor (carcinoid). He felt well without diarrhea, flushing, or abdominal pain. He had no other significant medical history. A smoker aunt had throat cancer. Physical examination findings were unremarkable. Gallium-68 dodecanetetraacetic acid tyrosine-3-octreotate (DOTATATE) positron emission tomography/computed tomography (PET/CT) with intravenous contrast was done to accurately stage the carcinoid. Three sites of intense DOTATATE uptake were found (Fig. 1, arrows): (1) terminal ileum (standard uptake value [SUV], 7.0) without associated soft-tissue abnormality; (2) left glossopharyngeal sulcus and left tongue base (SUV, 6.0) associated with asymmetric fullness at this location, mild left oropharyngeal narrowing, and a 2.1-cm left cervical node; and (3) uncinate process of the pancreas (SUV, 10.0) without an associated mass but with fatty atrophy of the pancreatic body and tail. For reference: the average SUV of liver and aorta were 5.4 and 0.5, respectively. What is the diagnosis?
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