Carcinoid syndrome

Carcinoid syndrome

Tumors arising from the cells of the endocrine system are known as carcinoid tumors. These tumors lead to over-secretion of certain hormones, which in turn give rise to a set of symptoms known as Carcinoid syndrome. Most cases are not diagnosed for several years until the carcinoid tumors are fairly advanced.

Causative & risk factors

Carcinoid syndrome is caused by the secretion of serotonin and other chemicals by carcinoid tumors. Not all carcinoid tumors can lead to this syndrome since the chemicals they release are usually neutralized by the liver. However the carcinoid tumors of the lungs and the liver itself release these chemicals directly into the bloodstream without neutralizing them. These chemicals in turn, give rise to symptoms of Carcinoid syndrome.

 

Clinical presentation

The symptoms of this condition are largely determined by the location of the carcinoid tumors and the chemicals they secrete. Flushing of the face (pink, red or purple) is a common feature and may be triggered by stress or exercise.

Patients usually suffer from cramps in the abdomen accompanied by diarrhea. Other symptoms include breathlessness, wheezing, palpitations and tachycardia.

 

Investigations

Since carcinoid syndrome produces non-specific, variable symptoms, the diagnosis can be easily missed.

Blood tests are performed to check chromogranin A. Urine testing is done to detect a substance called 5-HIAA.

Imaging tests such as X-rays, CT scans or MRI scans are used to look for carcinoid tumors. A specialized imaging test known as an octreoscan is performed after injecting the patient’s vein with a radioactive material and a specific substance.

Endoscopy with or without a biopsy examination is performed in areas that are suspected of having carcinoid tumors.

 

Treatment  

The primary treatment is surgical removal of the carcinoid tumors. When this is not possible, octreotide and other drugs are used to control the symptoms. Radiofrequency ablation therapy and cryotherapy are other treatment options. Chemotherapy works well for certain carcinoid tumors, especially the ones located in the pancreas.

Since carcinoids are usually slow-growing tumors, a patient with carcinoid syndrome has a fairly good prognosis.

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