? Carcinoid

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


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


  • 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


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