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Updated: Aug 29 2019

Carcinoid Tumor

  • 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
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