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Tsunenori Ozawa, Tadasu Terabayashi, Hitoshi Takahashi, Norio Takeda, Yasushi Ito, Akihiko Saito, Yoshiaki Sugiyama, and Fusahiro Ikuta

✓ A case of metastatic carcinoid tumor in the right occipital lobe originating from a primary tumor in the right colon is reported in a 68-year-old man. The tumor had a high bromodeoxyuridine labeling index. Although immunohistochemical studies of the tumor specimen showed positive reactivity for serotonin and somatostatin, blood levels of serotonin and urinary 5-hydroxyindoleacetic acid content were normal. This suggests that coexistence of somatostatin with serotonin in the tumor tissue might lead to inhibition of serotonin release by “autocrine regulation.” The neurological complications of carcinoid tumors, including intracranial metastasis, are discussed briefly.

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Akira Kurata, Hidehiro Oka, Taketomo Ohmomo, Hitoshi Ozawa, Sachio Suzuki, Kiyotaka Fujii, Shinichi Kan, Yoshio Miyasaka, and Harue Arai

✓ This 44-year-old man with Ehlers—Danlos syndrome (EDS) Type IV presented with hemiparesis and the Gerstmann syndrome. Left carotid artery (CA) angiography revealed a dissecting aneurysm with severe stenosis located in the common CA; the lesion was successfully treated with a stent graft. The patient's clinical course after endovascular surgery was uneventful, without occurrence of megacolon. The literature for spontaneous CA dissection in EDS Type IV cases is reviewed and points for investigation and treatment are discussed.