Introduction Tumor of neuroendocrine origin most common small bowel tumor Location most common sites are the rectum and stomach these foregut and hindgut masses rarely metastasize most common site of metastatic primary mass is terminal ileum appendix is common tumor site but too small to metastasize location determines whether or not carcinoid syndrome is present no carcinoid syndrome if the mass has not metastasized to the liver liver metabolizes 5-HT arriving in the portal circulation carcinoid syndrome is observed if tumor exists outside GI system Pathophysiology often produce 5-HT ectopically can lead to carcinoid syndrome Evaluation Biopsy dense core bodies seen on EM bodies are secretory granules bright yellow tumor Urinalysis 5-HT degraded to 5-HIAA and may be detected in the urine Treatment Pharmacologic hormone therapy somatostatin analogue to prevent extra hormones from being produced octreotide or lanreotide can help lessen flushing and diarrhea radiation and chemotherapy Surgical surgical resection can be done endoscopically, with local excision or with cryosurgery
QUESTIONS 1 of 3 1 2 3 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (M1.GI.13.55) A 53-year-old female visits her physician with watery diarrhea and episodic flushing. The patient reports that she is often short of breath, and a pulmonary exam reveals bilateral wheezing. A CT scan shows a mass in the terminal ileum. 24-hour urine collection shows abnormally elevated 5-hydroxyindoleacetic acid (HIAA) levels. Ultrasound demonstrates a tricuspid valve with signs of fibrosis with a normal mitral valve. A metastatic disease to which organ is most commonly associated with the patient's syndrome? Tested Concept QID: 101112 Type & Select Correct Answer 1 Lung 16% (9/57) 2 Kidney 4% (2/57) 3 Brain 0% (0/57) 4 Liver 65% (37/57) 5 Pancreas 5% (3/57) M 2 Question Complexity D Question Importance Select Answer to see Preferred Response SUBMIT RESPONSE 4 Review tested concept