Uld have been one of the adverse prognostic factors. This illustrates

Uld have been one of the adverse prognostic factors. This illustrates the need for repeated HAE to reduce tumor burden in our patient. Our patient also developed skin metastasis to a left chest wall lesion. The manifestation of skin metastases from carcinoid tumors has been reported in the past and is usually a sign of advanced disease.with palliative chemotherapy, locoregional treatment with HAE and cryoablation of the shoulder. She had partial relief of her right shoulder pain and relief of cachexia, as well as improved quality of life with the above treatments, before she died less than 2 years after her diagnosis.Consent Written informed consent for publication could not be obtained from our deceased patient's next of kin despite all reasonable attempts. Every effort has been made to protect D(+)-Galactosamine (hydrochloride) the identity of our patient and ensure anonymity.Abbreviations 5-HIAA: 5-Hydroxyindoleacetic acid; HAE: Hepatic artery embolization. Competing interests The authors declare that they have no competing interests. Authors' contributions NT wrote the manuscript. RO edited the manuscript and provided suggestions. Both authors read and approved the final manuscript. Acknowledgments We thank Dr Jeen Lee for contributing the pictures of the pathological slides. Author details 1 Department of Internal Medicine, Easton Hospital, School of Medicine, Drexel University, 250 South 21st Street, Easton, PA 18042, USA. 2Department of Hematology/Oncology, Easton Hospital, 250 South 21st Street, Easton, PA 18042, USA. Received: 31 December 2013 Accepted: 7 April 2014 Published: 7 May 2014 References 1. Crocetti E, Paci E: Malignant carcinoids in the USA, SEER 1992?999: an epidemiological study with 6830 cases. Eur J Cancer Prev 2003, 12:191?94. 2. Taal BG, Visser O: Epidemiology of neuroendocrine tumours. Neuroendocrinology 2004, 80(Suppl 1):3?. 3. Robertson RG, Geieger WJ, Davis NB: Carcinoid tumors. Am Fam Physician 2006, 74:429?34. 4. Zuetenhorst JM, Taal BG: Metastatic carcinoid tumors: a clinical review. Oncologist 2005, 10:123?31. 5. Meijer WG, van der Veer E, Jager PL, van der Jagt EJ, Piers BA, Kema IP, de Vries EG, Willemse PH: Bone metastases in carcinoid tumors: clinical features, imaging characteristics, and markers of bone metabolism. J Nucl Med 2003, 44:184?91. 6. Keiser J, Nakakura EK, Imhoff L, Mayorga MA, Bobiak S, Venook AP, Bergsland EK: Incidence and natural history of bone metastases in neuroendocrine tumors [Abstract]. J Clin Oncol 2012, 30(Suppl 4):340. 7. Hori T, Yasuda T, Suzuki K, Kanamori M, Kimura T: Skeletal metastasis of carcinoid tumors: two case reports and review of the literature. Oncol Lett 2012, 3:1105?108. 8. Feldman JM, O'Dorisio TM: Role of neuropeptides and serotonin in the diagnosis of carcinoid tumors. Am J Med 1986, 81:41?8. 9. Eriksson B, erg K, Stridsberg M: Tumor markers in neuroendocrine tumors. Digestion 2000, 62(Suppl 1):33?8. 10. erg K, Janson ET, Eriksson B: Tumour markers in neuroendocrine tumours. Ital J Gastroenterol Hepatol 1999, 31(Suppl 2):S160 162. 11. Nehar D, Lombard ohas C, Olivieri S, Claustrat B, Chayvialle JA, Penes MC, Sassolas G, Borson-Chazot F: Interest of chromogranin A for diagnosis and follow-up of endocrine tumours. Clin Endocrinol (Oxf) 2004, 60:644?52. 12. Modlin IM, Lye KD, Kidd M: A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003, 97:934?59.Conclusion Carcinoid tumors can arise from any PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/7500280 epithelial cell throughout the whole body and they can exhibit neuroendocrine behavior, alt.