Carcinoid syndrome
Cards (6)
- Carcinoid syndrome refers to a group of symptoms caused by the systemic release of different kinds of humoral factors like polypeptides, biogenic amines, and prostaglandins, mostly from well-differentiated neuroendocrine tumors.
- Carcinoid syndrome mostly occurs when there is metastasis to the liver. The liver usually inactivates the hormones but cannot if there is liver dysfunction due to mets.
- Symptoms:
- Flushing
- Tachycardia
- Diarrhoea
- Right sided heart failure or valvular disease
- Bronchospasm
- Pellagra (vitamin B3 deficiency - dermatitis, diarrhoea and mental disturbance)
- 24 hr urine 5-HIAA is the initial diagnostic test (end product of serotonin metabolism)
- Chromogranin A is a glycoprotein secreted by neuroendocrine tumors. It is useful for the detection of the non-secreting tumor.
- Management:
- Somatostatin analogues - slows down the production of hormones (especially serotonin)
- Niacin (B3) supplementation
- Resection
- Chemotherapy if malignant