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Endocrine Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
A 33-year-old male who underwent a laparoscopic appendicectomy 2 weeks ago has been referred to your endocrine clinic. The histology report confirms an 18 mm carcinoid tumour in the tip of the appendix. What is a carcinoid tumour?Carcinoid tumours are of neuroendocrine origin; the term now specifically applies to tumours of the midgut origin (jejunoileal and proximal colon).They predominantly secrete serotonin; stain with chromogranin A and synaptophysin immunostains.
Involvement of Dopamine with Various Cancers
Published in Nira Ben-Jonathan, Dopamine, 2020
Carcinoid tumors, a subset of NET, usually begin in the digestive tract (stomach, appendix, small intestine, colon, rectum) or in the lungs. They often do not cause signs and symptoms until late in the disease. Advanced carcinoid tumors can produce and release catecholamines or serotonin that cause signs and symptoms, collectively called a carcinoid syndrome, that include diarrhea, skin flushing, abdominal cramping, difficulty breathing, rapid heartbeat, and peripheral edema.
The Stomach
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Carcinoid tumors: surgery is the primary treatment for these tumors even in the presence of metastases. Small tumors of up to 1 cm can be locally resected. Tumors greater that 1 cm should be treated as carcinoma in the absence of metastases. Those with locally and regionally advanced disease should undergo complete resection, if possible, as they have long survivals. Patients with metastases who have the syndrome can be treated sympto-matically according to the clinical presentation.
Carcinoid Heart Disease
Published in Structural Heart, 2020
Amin Sabet, Mina Haghighiabyaneh, Chirag Rajyaguru, Ajit Raisinghani, Daniel Kupsky, Anthony N. DeMaria
Carcinoid tumors are rare neuroendocrine malignancies, occurring primarily in the gastrointestinal tract and secondarily in the bronchopulmonary system and gonads.1 They usually grow slowly over years and cause no or minimal symptoms until they have grown to a large size or metastasized. Approximately 40% of patients present with the classic features of the carcinoid syndrome; a symptom complex caused by tumor production of vasoactive substances that are inactivated by the liver. Therefore, carcinoid syndrome usually occurs when the tumor metastasizes to the liver. Clinically, the syndrome is usually manifested by episodes of flushing, hypotension, secretory diarrhea, bronchospasm and less frequently hypertension.2,3 Carcinoid heart disease (CHD), first reported in 1954, develops in more than 50% of patients with the carcinoid syndrome.4–6 It is associated with fibrous plaque–like endocardial thickening that can cause retraction and fixation of the right-sided heart valves. The pathophysiology of carcinoid heart disease is thought to be multifactorial and caused by chronic exposure to excessive circulating vasoactive substances.5–9 The prognosis of patients with CHD treated medically is poor, and surgical mortality is also high.10–13
Clinical outcome and comparison between squamous and non-squamous cell carcinoma of the larynx
Published in Acta Oto-Laryngologica, 2020
Le Chen, Weiye Deng, Cai Li, Huiching Lau, Lei Tao, Shuyi Wang, Liang Zhou, Ming Zhang
NECs of the larynx have been recognized as the most common nSCC type arising in this area, accounting for 0.3–0.5% of all laryngeal neoplasms [12]. Atypical carcinoid tumors are the most common histopathological type and are generally considered to be aggressive. Surgical excision is the main treatment of choice for typical and atypical carcinoid tumors, and selective neck dissection should also be performed in the latter. Small-cell NEC is a highly aggressive malignancy, and it must be approached as a systemic disease, as the absence of regional or distant metastasis does not preclude the presence of micrometastasis [13]. These tumors are mainly treated by surgery and systemic multi-agent chemotherapy and radiotherapy [14], and the therapeutic approach may likely vary to a certain degree according to the stage of the disease at diagnosis. Early metastases are exceedingly common and >90% patients with laryngeal small-cell NEC develop metastatic disease. Once the diagnosis is established, a full metastatic workup is mandatory. The most common sites of metastatic spread of this aggressive neoplasm are the cervical lymph nodes, liver, lungs, bones and bone marrow. Among the 9 cases of small cell carcinoma, 4 cases were accompanied by cervical lymph node metastasis. In our study, the average survival time was 141.6 months.
Use of 68Ga DOTATATE, a new molecular imaging agent, for neuroendocrine tumors
Published in Baylor University Medical Center Proceedings, 2020
Raymond Andrew LeBlanc, Umesh D. Oza, Ryan Hayden, Hanna Fanous
A 74-year-old man presented with abdominal pain, and an ultrasound showed cholelithiasis but no findings for acute cholecystitis. CT of the abdomen and pelvis with intravenous and oral contrast showed a small, partially calcified mass in the right lower quadrant mesentery and a small filling defect in his distal small bowel (Figure 1a). These findings raised suspicion for carcinoid tumor. Imaging with 68Ga DOTATATE PET-CT scan showed avid tracer uptake within a focal mass within the terminal ilium that corresponded to the soft tissue mass with calcified deposits and intraluminal filling defect on the previous CT abdomen and pelvis (Figure 1b). This was presumed to be the primary lesion, as no other lesion was identified within the imaged body. The calcified mesenteric mass and the small bowel mass were resected, and surgical pathology showed well-differentiated neuroendocrine tumor, grade I. The patient did well postoperatively.