Case history
Case history #1
A 60-year-old man presents with a 3-year history of diarrhoea, with no clear precipitating factors. Over the past few months he has noticed flushing affecting his face. These episodes occur at any time but are worse during times of stress and exercise. His wife has also noticed intermittent reddening of his face, which lasts for a few minutes. More recently he has not tolerated alcohol, chocolate, or bananas.
Case history #2
A 50-year-old woman presents with a long history of atypical flushing, initially attributed to menopause. The flushing is associated with purplish discolouration of the face with each episode lasting 30 minutes. She also reports palpitations on exertion and recurrent episodes of abdominal pain.
Other presentations
Coincidental finding of liver metastases while other unrelated symptoms are being investigated is an alternative presentation. Other presentations include occasional abdominal pain, especially following large meals, and associated weight loss. Recurrent abdominal pain leading to development of sub-acute bowel obstruction can also occur. Patients can also present with cardiac signs, such as right heart failure and cardiac murmurs.
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