A Case of Carcinoid Syndrome with a Scleroderma-like Lesion

Park, Young Do; Kim, Sung Ae; Cho, Jae We; Lee, Kyu Suk

Abstract

Carcinoid syndrome exhibits a constellation of symptoms typically exhibited by patients with carcinoid tumors that produce neuroendocrine mediators, including serotonin. Carcinoid syndrome is diagnosed by increasing urinary 5-hydroxyindoleacetic acid and manifestations of gastrointestinal tract, respiratory, cardiovascular, and skin involvement, which occurs in <10% of patients. Cutaneous manifestations are flushing, telangiectasias, pellagra dermatitis, and scleroderma-like lesions, which are relatively rare. A 60-year-old woman presented with sclerotic skin lesions on both legs. On examination, a 10x10 cm solid mass was palpable on the right lower abdomen, and she had facial flushing and telangiectasia, but Raynaud's phenomenon was absent. The urinary 5-hydroxyindoleacetic acid was elevated (68.2 mg/day). Abdominal and pelvic CT scans showed a right ovarian tumor which was diagnosed as a carcinoid tumor by CT-guided needle biopsy. Thus, we report, for the first time, a case of carcinoid syndrome with scleroderma-like lesions in a Korean patient. If facial flushing and a scleroderma-like lesion present together, one should consider a carcinoid tumor.