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ALL / Gastroenterology

Carcinoid tumours

Carcinoid tumours

Carcinoid syndrome
  • usually occurs when metastases are present in the liver and release serotonin into the systemic circulation
  • may also occur with lung carcinoid as mediators are not 'cleared' by the liver

Pathophysiology of carcinoid tumours

Features
  • flushing (often the earliest symptom)
  • diarrhoea
  • bronchospasm
  • hypotension
  • right heart valvular stenosis (left heart can be affected in bronchial carcinoid)
  • other molecules such as ACTH and GHRH may also be secreted resulting in, for example, Cushing's syndrome
  • pellagra (niacin deficiency) can develop as dietary tryptophan is diverted to serotonin by the tumour

Investigation
  • urinary 5-HIAA
  • plasma chromogranin A y

Management
  • somatostatin analogues e.g. octreotide
  • diarrhoea: cyproheptadine may help
+PassMedicine Notes
Carcinoid syndrome
  • usually occurs when metastases are present in the liver and release serotonin into the systemic circulation
  • may also occur with lung carcinoid as mediators are not 'cleared' by the liver
Features
  • flushing (often the earliest symptom)
  • diarrhoea
  • bronchospasm
  • hypotension
  • right heart valvular stenosis (left heart can be affected in bronchial carcinoid)
  • other molecules such as ACTH and GHRH may also be secreted resulting in, for example, Cushing's syndrome
  • pellagra (niacin deficiency) can develop as dietary tryptophan is diverted to serotonin by the tumour
Investigation
  • urinary 5-HIAA
  • plasma chromogranin A y
Management
  • somatostatin analogues e.g. octreotide
  • diarrhoea: cyproheptadine may help


Media
Carcinoid syndrome
Osmosis - YouTube
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Carcinoid syndrome
YouTube
👍 71 👎 4
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