THE CARCINOID syndrome occurs in association with primary carcinoid tumors originating in various organs, usually when metastases to the liver have occurred. Carcinoid tumors may originate from argentaffin cells which extend from the cardia of the stomach to the anus.1,2 The primary tumor usually is located in the intestine, especially in those organs comprising the embryological midgut (lower duodenum, jejunum, ileum, and cecum).3 The terminal ileum is the primary site of origin of the tumor in most patients with the syndrome. Appendiceal lesions are even more common, but metastases rarely occur and the syndrome is infrequently noted. The syndrome also has been seen in patients with tumors originating from less common sites, namely the pancreas, stomach, gallbladder, and parotid gland.1,4-6 Metastases, but not the syndrome, have been described with rectal carcinoids.3,7 Carcinoid tumors also may originate in teratomas of the testes and of the retroperitoneal space. Usually ovarian carcinoid tumors