Carcinoid Syndrome — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateEndocrinologyCarcinoid SyndromeRACP Adult Medicine

A 42-year-old man presents with episodic flushing, diarrhoea, and wheezing. He has a palpable hepatomegaly. CT shows a 3 cm ileal mass and multiple liver metastases. 24-hour urine 5-HIAA is markedly elevated. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Carcinoid syndrome

Episodic flushing, secretory diarrhoea, and bronchospasm with ileal mass, liver metastases, and elevated 5-HIAA is carcinoid syndrome. Carcinoid syndrome occurs when vasoactive amines (serotonin) bypass hepatic metabolism — typically with liver metastases. Treatment includes somatostatin analogues (octreotide LAR), and surgical debulking or liver-directed therapy. Echocardiography for carcinoid heart disease.

Reference: ENETS – 2024 – NET Guidelines; NCCN 2025