Carcinoid tumours and syndrome

Question 1

What is a carcinoid tumour?

Answer 1

Poorly malignant tumours of enterochromaffin cells (neuroendocrine cells which produce hormones) which produce SEROTONIN/5-HT and histamine (vasodilators)

Question 2

Where are carcinoid tumours mostly found?

Answer 2

Mostly GIT - appendix and terminal ileum
Also in lungs

Question 3

What are carcinoid tumours?

Answer 3

Only the neoplastic cells
No Sx or v little

Question 4

What is carcinoid syndrome?

Answer 4

When tumour metastasises to liver
lots of Sx

Question 5

Sx?

Answer 5

Flushing, Diarrhoea, tricuspid incompetence (valve lesion)
May have RUQ pain and resp problems

Question 6

Dx?

Answer 6

Liver ultrasound - +ve mets

Increased 5HIAA (Hydroxyindoleacetic acid, major 5HT metabolite) in urine

CT/MRI to locate 1^ tumour

Question 7

Tx?

Answer 7

Surgically excise 1^ tumour (definitive)
Octreotide (SST -somatostatin analogue) can block hormones

Question 8

Complication of carcinoid tumours/syndrome?

Answer 8

Carcinoid crisis - life threatening Sx constellation

Question 9

Tx for carcinoid crisis?

Answer 9

SST analogues in a high dose