Right Heart Failure as “Sole” Presentation of Carcinoid Syndrome

Carcinoid tumors are rare neuroendocrine tumors that arise from neural crest amine precursor uptake decarboxylation cells. Most of carcinoid tumors originate in the midgut. The vasoactive secretory products of carcinoid tumor upon metastasis to liver reach systemic circulation as they bypass the metabolism by liver. 50% of patients with carcinoid syndrome eventually develop carcinoid heart disease. We here present a rare case of carcinoid tumor with metastasis to liver that solely presented with right heart failure. The patient did not have any symptoms of typical carcinoid syndrome features such as flushing, diarrhea, and bronchoconstriction.