Carcinoid tumor of the gastrointestinal tract with metastases to the brain.

A 56-year-old women with carcinoid tumor of the gastrointestinal tract, which was metastatic to the mesenteric lymph nodes, was seen four months after bowel resection with new neurologic findings. Results of an initial examination suggested infection with mycobacteria, or fungi, but the condition of the patient deteriorated, and she died after antituberculous and antifungal therapy was begun. She never suffered from carcinoid syndrome, and 5-hydroxyindoleacetic acid and 5-hydroxytryptamine were not detected in blood samples. A postmortem examination disclosed widespread metastases of carcinoid tumor, including invasion of the cerebral hemispheres. In this article, CNS metastasis of carcinoid tumors is discussed as well as the possibility that drug interactions may have contributed to some of the patient's neurologic findings.