Cardiac Pathology: Neoplasia: Carcinoid
A 1969 autopsy specimen from a 62 year old man who was admitted for investigation of apparent polycythaemia. He had noticed increasing reddish-blue discolouration of his face for about six months previously and had had periodic bouts of diarrhoea. On examination, he was found to have a large, hard, knobbly liver and a varying cardiac murmur at the lower border of the sternum. He was thought to have the "carcinoid syndrome" with liver metastases, probably secondary to a primary carcinoid tumour in the small intestine. The finding of a grossly elevated urinary 5-hydroxy indole acetic acid excretion confirmed the diagnosis. Despite his inoperable liver metastases he remained well, without symptoms for fifteen months, but then deteriorated suddenly and died.