carcinoid syndrome

Question 1

define carcinoid syndrome?

Answer 1

constellation of symptoms caused by systemic release of humoral factors from carcinoid tumours

Question 2

what is the aetiology of carcinoid syndrome?

Answer 2

• they are slow growing tumours
• mostly derived from serotonin-producing enterochromaffin cells
• mostly start in the small bowel or the lungs
• only become symptomatic when it spreads to the liver as then the serotonin cant be broken down

Question 3

epidemiology of carcinoid syndrome?

Answer 3

• rare

- 10% of patients with MEN-1 have carcinoid tumours

Question 4

what are the presenting symptoms of carcinoid syndrome?

Answer 4

• Paroxysmal FLUSHING
• Diarrhoea
• Crampy abdominal pain

Question 5

what are signs of a carcinoid crisis?

Answer 5

o Profound flushing
o Bronchospasm
o Tachycardia
o hypotension

Question 6

what are the best investigations for carcinoid syndrome?

Answer 6

o Check for raised 5-HIAA levels (metabolite of serotonin)

o Plasma chromogranin A and B