A 51-year-old woman with a 10-year history of irritable bowel syndrome manifested by
intermittent abdominal cramps, bloating, and watery diarrhea developed worsening
symptoms and new-onset dyspepsia. EGD revealed a small nodule in the duodenal bulb,
biopsy specimens of which revealed a carcinoid tumor. She was subsequently referred for
endoscopic resection of the lesion (A). There were no clinical features to suggest carcinoid
syndrome. Laboratory values were as follows: urinary 5-hydroxyindoleacetic acid screen …