Tumor

Question 1

Carcinoid heart disease

Answer 1

advanced neuroendocrine tumours –> carcinoid syndrome, involving the right-sided heart valves –> right heart failure. Related to aberrant serotonin release

Question 2

Treatment for Carcinoid heart disease

Answer 2

a. somatostatin analogues
b. hepatic artery interruption
c. Cardiac surgery is only effective treatment for symptomatic patients with metastatic carcinoid heart disease

Question 3

Valve affected by carcinoid heart disease

Answer 3

tricuspid and pulm valve. Valve replacement is usually mandatory: bioprosthetic valves may be affected by serotonin release but anticoagulation may cause bleeding from hepatic lesions

Question 4

Carney Complex features

Answer 4

Multiple endocrine neoplasia syndrome 
- pigmented lesions of the skin and mucosa (lentiginosis)
- recurrent atrial myxoma
- noncardiac myxomatous tumors 
- multiple endocrine tumors 
- ACTH-independent hypercortisolism`
PRKAR1A tumor suppressor gene. Autosomal dominant.
Usually start between 10-20 years of age

Question 5

Surveillance of patients with Carney complex

Answer 5

Surveillance echocardiograms needed for life