carcinoid syndrome


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Related to carcinoid syndrome: Carcinoid tumor

carcinoid

 [kahr´sĭ-noid]
1. a yellow circumscribed tumor of the gastrointestinal tract or bronchus formed from chromaffin cells. See also carcinoid syndrome.
carcinoid syndrome a symptom complex associated with carcinoid tumors (argentaffinomas), marked by attacks of severe cyanotic flushing of the skin lasting from minutes to days and by watery diarrhea, bronchoconstrictive attacks, sudden drops in blood pressure, edema, and ascites. Symptoms are caused by serotonin, prostaglandins, and other biologically active substances secreted by the tumor.

The specific symptoms associated with this disorder depend upon the site of the primary tumor; tumors are found most commonly in the appendix and the terminal third of the ileum but can also be in the bronchi, ovaries, testes, and anywhere along the entire length of the alimentary tract. The full set of carcinoid symptoms are manifested only when the liver is involved.

Diagnosis of the condition is established by a 24-hour urine test for 5-hydroxyindoleacetic acid (5-HIAA), the end product of the breakdown of tryptophan to serotonin. Patients with carcinoid syndrome may have very high levels of 5-HIAA, 100 to 500 mg in 24 hours.

Carcinoid tumors are not always benign and should be approached as if they were malignant growths. Surgical excision of the tumor and any associated mesenteric nodes is the treatment of choice. Chemotherapy can be used with metastatic disease, and other drugs are prescribed as indicated to manage the hypotension, diarrhea, flushing, and other symptoms. Efforts are made to improve nutrition and to avoid serotonin-containing foods, such as walnuts and bananas, which are known to precipitate an attack and make accurate diagnosis difficult.

car·ci·noid syn·drome

a combination of symptoms and lesions mostly produced by the release of serotonin from carcinoid tumors of the gastrointestinal tract that have metastasized to the liver; consists of irregular mottled blushing, flat angiomas of the skin, acquired tricuspid and pulmonary stenosis often with regurgitation, occasionally with some minor involvement of valves on the left side of the heart, diarrhea, bronchial spasm, mental aberration, and excretion of large quantities of 5-hydroxyindoleacetic acid.

carcinoid syndrome

Oncology A symptom complex caused by carcinoids, which arise from the enterochromaffin system, a system most concentrated in the midgut; carcinoids release vasoactive substances–eg, serotonin, and its metabolite, 5-HIAA, as well as bradykinin, histamine, PG, substance P; serotonin's precursor is tryptophan, used by the body to produce niacin and some proteins; carcinoid Sx are most common in metastases, often from a primary ileal carcinoid metastatic to the liver Clinical Episodic skin flushing on the face, spreading to the trunk, then telangiectasia, precipitated by alcohol, food, stress, or liver palpation; also diarrhea or GI obstructive symptoms, bronchospasm, wheezing, pleural, peritoneal, retroperitoneal, endocardial fibrosis of the right valves and right ventricular wall, which may cause failure, carcinoid myopathy and atrophy of type II muscle fibers Lab ↑ Serotonin, 5-HIAA in serum, urine Management Resection. See APUD system, Atypical carcinoid.

car·ci·noid syn·drome

(kahr'si-noyd sin'drōm)
A combination of symptoms and lesions usually produced by the release of serotonin from carcinoid tumors of the gastrointestinal tract that have metastasized to the liver; consists of irregular mottled blushing, flat angiomas of the skin, acquired tricuspid and pulmonary stenosis often with regurgitation, diarrhea, bronchial spasm, mental aberration, and excretion of large quantities of 5-hydroxyindoleacetic acid. Surgical excision is performed when feasible. Treatment may include chemotherapy and radiation therapy.

carcinoid syndrome

A rare condition in which bowel tumours of cells of endocrine origin spread to other parts of the body and secrete large quantities of highly active substances such as SEROTONIN, HISTAMINE, BRADYKININ, ACTH, INSULIN or growth hormone. These cause symptoms such as flushing, diarrhoea, cramping abdominal pain, serious heart damage, arthritis and asthma. Carcinoid syndrome produces unpredictable and severe swings of blood pressure during general anaesthesia calling for careful anaesthetic management. The SOMATOSTATIN analogue drug octreotide (Sandostatin) is important in this context.

Carcinoid syndrome

The pattern of symptoms (often including asthma and diarrhea) associated with carcinoid tumors of the digestive tract or lungs.

Patient discussion about carcinoid syndrome

Q. what is carcinoid tumors? I had my appendix removed and the doctor came in the room very shocked and said it was full of carcinoid tumors. Im scared to get them somewhere else.

A. ya I have pain all the time but the doctors wont give me anything cuz im so young they don't want me hooked on anything. thank you sooo much for being so kind.

More discussions about carcinoid syndrome
References in periodicals archive ?
Octreotide treatment resulted in control of carcinoid syndrome and tumor reduction or complete regression in 43% of patients with liver metastases of pulmonary atypical carcinoid [17].
Kvols, "Therapeutic considerations for the malignant carcinoid syndrome," Acta Oncologica, vol.
Primary site Pancreas Gastrointestinal tract (ileum, stomach, and appendix) Number of pts 37 27 Age median (range) 59.5 (30-79) 57(21-78) 9 insulinoma -- Syndrome 1 carcinoid syndrome 2 carcinoid syndrome 1 ZES 1 ZES Stage I-II: 22 I-II: 10 IIIB-IV: 15 IIIB-IV: 17 Ki67 median (range) 1.8% (0.1-18.8%) 2.3% (0.5-12.4%) Grading G1: 21 (56.8%) G1: 18 (66.7%) G2: 16 (43.2%) G2: 9 (33.3%) Follow-up Median 69.5 months (range: 4-140 months) Primary site Total Number of pts 64 (M: 26) Age median (range) 59 (21-79) 9 insulinoma Syndrome 3 carcinoid syndrome 2 ZES Stage I-II: 32 IIIB-IV: 32 Ki67 median (range) 1.8% (0.1-18.8%) Grading G1: 39 (60.9%) G2: 25 (39.1%) Follow-up ZES: Zollinger-Ellison syndrome.
Somatostatin analogs alone or in combination with surgery, radiation, or embolization have been successfully used for control of symptoms in patients with advanced NETs who develop carcinoid syndrome. Yet, a significant proportion of these patients remain refractory to treatment with SA and suffer from debilitating symptoms of serotonin overproduction [75].
Bommelaer et al., "Treatment of carcinoid syndrome: a prospective crossover evaluation of lanreotide versus octreotide in terms of efficacy, patient acceptability, and tolerance," Cancer, vol.
(4) The term neuroendocrine neoplasm has been accepted as general nomenclature instead of carcinoid because carcinoid does not convey the malignant nature of the tumors and can be confused with carcinoid syndrome. (2,20)
Other rare causes of mitral valve (MV) obstruction include congenital MS, degenerative mitral annular calcification, atrial myxomas, large thrombus or vegetations, systemic lupus erythematosus (SLE) and carcinoid syndrome.
Other features include abdominal discomfort (24.6%) and acute pancreatitis (6.0%).6 Our patient did not exhibit any features suggestive of carcinoid syndrome (flushing, diarrhoea, etc.) which is consistent with the reports of rarity of carcinoid syndrome in these tumours (less than 3%).3
Flushing, diarrhea, Cushing syndrome or carcinoid syndrome were not observed.
Given the location of the tumor and concomitant vasomotor symptoms, the diagnosis of carcinoid syndrome was entertained.