A 35-yrs-old woman complains of attacks of breathlessness, cyanosis and flushing. Apart from occasional diarrhea she has no abdominal symptoms. Abdominal examination reveals an enlarged nodular liver. If laparotomy is done, we could expect to find:

History of breathlessness, cyanosis and flushing points towards carcinoid syndrome. Enlarged nodular liver means hepatic metastasis, which is essential to produce carcinoid syndrome. Appendicular carcinoids are detected in I in ever) 200-300 appendicectomies. It is one of the commonest sites for carcinoid tumours. Carcinoid tumours are commonly seen in appendix, small intestine, lungs, stomach etc. Flushing, diarrhoea, wheezing, pellagra like skin lesions are the common features. Carcinoid tumours secrete large amount of serotonin. Treatment is with somatostatin analogues like octreotide,lanreotide etc. Surgery is done whenever possible to remove the tumours.