Physical Examination 
• Abdominal mass and enlarged liver.
• Prominent skin veins (telangiectasis). 
• Signs of the carcinoid syndrome—heart murmur, wheezing on expiration and flushing of the skin.

Blood and Other Tests 
• Metastatic carcinoid tumors may be diagnosed by elevated levels of 24-hour urinary 5-hydroxyindolacetic acid
  (5-HIAA), a metabolic product of the serotonin produced by the tumor. False positive 5-HIAA tests can be
  caused by foods such as bananas, avocados and pineapple and by certain drugs. The laboratory should provide
  a complete list of foods to be avoided during urine collection.

Imaging 
• X-rays of the chest and gastrointestinal tract (small bowel and barium enema).
• CT or MRI scan of the abdomen to detect liver metastases.

Endoscopy and Biopsy 
• Liver biopsy, if indicated.