70. Carcinoid Tumours

Question 1

What are carcinoid tumours?

Answer 1

Diverse group of enterochromaffin cells that produce 5HT

Question 2

What are enterochromaffin cells?

What is 5HT?

Answer 2

Type of enteroendocrine cell that reside along the lumen of the GI tract controlling motility and secretion

5HT= serotonin. Acts as a neurotransmitter and a hormone

Question 3

What are the common sites for these carcinoid tumours?

Answer 3

Appendix (45%)
Ilium (30%)
Rectum (20%)

Question 4

What is a carcinoid syndrome?

Answer 4

Implies carcinoid tumours with hepatic involvement

Question 5

What are the signs of carcinoid tumours?

Answer 5

Bronchoconstriction
Diarrhoea
CCF
Paraxosymal flushing

Question 6

What is meant by a carcinoid crisis?

How is it treated?

Answer 6

When a tumour outgrows it’s blood supply mediators flood out. This leads to life threatening vasodilation, hypotension, tachycardia, bronchoconstriction and hyperglycaemia.

High dose octreotide, (somatostatin analogue)
fluid mangement through a central line

Question 7

What are the tests of carcinoid tumours

Answer 7

24 urine 5-hydroxyindoleactic acid
CXR
Chest/pelvis MRI/CT
Plasma chromogranin A

Question 8

What is the treatment of carcinoid tumours?

Answer 8

Octreotide- blocks release of tumour mediators and counters peripheral effects

Loperamide for diorrhea

Resection is the only cure for carcinoid tumours