Carcinoid Tumor

Carcinoid tumor is a type of neuroendocrine tumor Pathophysiology 1) contains and may secrete physiologically active substances 2) occurs in GI tract (appendix, rectum, small bowel, stomach), thymus, lung, ovary, and testes 3) produces “local” symptoms, systemic but non-carcinoid syndrome symptoms, and systemic carcinoid syndrome symptoms Signs and Symptoms of Carcinoid Tumor Local Symptoms 1) appendix – usually asymptomatic and found incidentally on appendectomy 2) small intestine – obstruction, episodic abdominal pain, bleeding 3) rectum – bleeding, constipation, and diarrhea 4) stomach/thymus/lung/ovary/testes – usually asymptomatic Systemic Non-carcinoid Tumor Syndrome Symptoms 5) Cushing’s syndrome 6) acromegaly 7) hypergastrinemia Systemic Carcinoid Tumor Syndrome Symptoms 8) flushing (especially in face and neck) 9) pruritus 10) lacrimation and salivation 11) hypotension 12) diarrhea 13) asthma/wheezing 14) pulmonic stenosis and tricuspid regurgitation 15) pellagra-like skin lesions Characteristic Test Findings Laboratory 1) increased 5-HIAA in urine Radiology 2) mass lesion on chest radiograph for lung and thymus carcinoids Histology/Gross Pathology 1) in appendix – located usually in tip with metastases unusual if < 1 cm 2) in small intestine – usually multiple (most common in ileum with marked fibrotic reaction) with metastases in 25% of cases even when < 1 cm 3) in rectum – usually small with metasta...
Source: Inside Surgery - Category: Surgeons Authors: Tags: Oncology 5-HIAA appendix flushing GI metastases motilin serotonin Source Type: blogs