Abstract
A 78 year old man presented with diarrhoea, anorexia, and progressive lower limb oedema. He was in atrial fibrillation and had a right pleural effusion and ascites. Ultrasound of the abdomen and 24 hour urinary hydroxyindoleacetic acid output indicated metastatic carcinoid syndrome. Cardiac catheterisation revealed pericardial constriction, and pericardial exploration showed a greatly thickened pericardium with no evidence of tumour invasion. The patient died within 24 hours of surgery. Necropsy findings were consistent with a diagnosis of constrictive pericarditis secondary to metastatic carcinoid syndrome. Keywords: carcinoid syndrome; constrictive pericarditis; liver metastases
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Figure 1 .
Low power view of the tumour nests in the lamina propria (original magnification ×100).
Figure 2 .
Pericardium showing hyaline fibrosis and chronic inflammation.