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- Physical Examination
- • Abdominal mass and enlarged liver.
- • Prominent skin veins (telangiectasis).
- • Signs of the carcinoid syndrome—heart murmur, wheezing on expiration and flushing of the skin.
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- Blood and Other Tests
- • Metastatic carcinoid tumors may be diagnosed by elevated levels of 24-hour urinary 5-hydroxyindolacetic acid
- (5-HIAA), a metabolic product of the serotonin produced by the tumor. False positive 5-HIAA tests can be
- caused by foods such as bananas, avocados and pineapple and by certain drugs. The laboratory should provide
- a complete list of foods to be avoided during urine collection.
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- Imaging
- • X-rays of the chest and gastrointestinal tract (small bowel and barium enema).
- • CT or MRI scan of the abdomen to detect liver metastases.
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- Endoscopy and Biopsy
- • Liver biopsy, if indicated.
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