Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of metastatic neuroendocrine tumor (NET) to the liver. Primary site: [Primary Site]. Current symptoms include [flushing/diarrhea/abdominal pain/weight loss/asymptomatic]. Patient reports [stable/progressive] symptoms. Current somatostatin analog therapy: [Drug/Dose/Frequency]. No reported symptoms of carcinoid crisis.
Clinical Examination Findings
Abdominal examination: Liver is [palpable/non-palpable], [tender/non-tender], with [smooth/nodular] edge. Hepatomegaly noted. No evidence of ascites or caput medusae. Skin: [Presence/absence] of cutaneous flushing or telangiectasia. Cardiovascular: Heart sounds regular, no murmurs suggestive of carcinoid heart disease.
Treatment Protocol
Plan: Continue somatostatin analog therapy ([Octreotide/Lanreotide]). Consider PRRT (Peptide Receptor Radionuclide Therapy) if disease progression is noted. Monitor Chromogranin A levels and liver function tests. Schedule follow-up triphasic CT/MRI liver to assess tumor burden. Evaluate for surgical resection or liver-directed therapy (TACE/Y-90) if indicated.