Carcinoid Tumours

Question 1

When does carcinoid syndrome occur?

Answer 1

When metastases are present in the liver and release serotonin into the systemic circulation
When lung carcinoid mediators are not cleared by the liver

Question 2

Presentation of carcinoid syndrome

Answer 2

Flushing
Diarrhoea
Bronchospasm 
Hypotension 
Right valvular heart stenosis 
Possible cushings syndrome depending on secretions

Question 3

What is often the earliest symptom of carcinoid syndrome?

Answer 3

Flushing

Question 4

Investigations of carcinoid syndrome

Answer 4

Urinary 5-HIAA

Plasma chromogranin Y

Question 5

Treatment of carcinoid syndrome

Answer 5

Somastatin analogues e.g. octreotide

Cyprohepatidine may help the diarrhoea