53 yo lady for EUA rectum/biopsy – rectal mass. Recent colonoscopy

Issues:

• Potential neuroendocrine disease secondary to rectal mass – flushing, tachycardia, and sweats
• PET-avid thyroid nodule as well.
• Note: Patient thought she was peri menopausal.

Discussion:

• Endocrine discussion – carcinoid? Chromograffin A – mildly elevated. Not significant and no increased risk of Carcinoid disease or syndrome as per endocrine and surgeon.
• TSH – low 0.16. ? hyperthyroid. T3 and T4 pending. Would that be a reasonable explanation?
• Any further tests required? Can we test to see if patient is menopausal – discuss with Gynae

Plan:

• Free T3/T4 – normal 
• FSH and LH – normal 
• Discussed with endocrine : no further investigation or management indicated. Unlikely menopausal. 
• Proceed to surgery.