Carcinoid Tumour and Syndrome

Question 1

Definition

Answer 1

Tumour of ENTEROCHROMAFFIN CELLS -
Release of excess 5HT/serotonin + other vasoactive peptides into systemic circulation from a carcinoid tumour of the neuroendocrine cells - ALL MALIGNANT

Question 2

Risk Factor (only 1)

Answer 2

MEN1

Question 3

Where?

Answer 3

Mostly Gastrointestinal tract at Appendix and Terminal Ileum

Question 4

Carcinoid Tumour Definition

Answer 4

Only the neoplastic cells - no symptoms

Question 5

Carcinoid syndrome Defintion

Answer 5

when tumour metastasises to liver - constellation of Sx

Question 6

Signs and Symptoms

Answer 6

FLUSHING (vasodilation - bradykinin)
DIARHHOEA
WHEEZING
TRICUSPID INCOMPETANCE (Valve lesion)
May have RUQ pain
Itching (histamine)
Pellagra

Question 7

Diagnosis

Answer 7

Liver USS - +ve mets
Urinalysis = 5 hydroxyindoleacetic acid increased
Bloods - niacin def
CT to locate tumours

Question 8

Treatment

Answer 8

GOLD STANDARD = Surgically excise primary tumour
Somatostatin analogue - OCTEOTRIDE can block tumour hormones

Question 9

Complications

Answer 9

Carcinoid crisis = life threatening
Treat with high dose OCTEROTRIDE