This has often been present for a number of years. Many patients have had numerous normal investigations. Urgent surgery, as in this case, has often been precipitated by the onset of intestinal obstruction. Symptoms include diarrhoea and flushing. The flushing is usually intermittent and lasting for only several minutes.
Episodes become more frequent as the disease progresses.
Flushing may be precipitated by the ingestion of either chocolate or alcohol and is often associated with palpitations and episodes of hypotension. Clinical examination is often normal. A right-sided abdominal mass or hepatomegaly may be present. In those with carcinoid syndrome features of pellagra, tricuspid regurgitation or pulmonary stenosis may be present. Bronchial carcinoid have been reported to produce ACTH resulting in Cushing's syndrome.