Patients with carcinoid syndrome
often have metastasis to the liver, where serotonin is normally metabolized.
The signs or symptoms of carcinoid syndrome
Update on carcinoid syndrome
. AANA J 1997; 65: 265-70.
Zheng, "Primary hepatic carcinoid tumours: clinical features with an emphasis on carcinoid syndrome
and recurrence," The Journal of International Medical Research, vol.
Blood 5-hydroxyindole acetate (5-HIAA), urine 5-HIAA, and serotonin degradation metabolite levels were elevated at 1121 ng/ml (NR 57-230 ng/ml), 472 ng/ml (NR 1.8-6.1 ng/ml), and 86.9mg/13h (NR 1-6mg/24h), respectively, confirming the diagnosis of carcinoid syndrome
. Chest CT showed no abnormalities.
Tumor size and the presence of carcinoid syndrome
are the two important predictors of metastasis which might reach 16% roughly and hence the need for follow-up.
The occurrence of carcinoid syndrome
or symptoms of Cushing's syndrome are rare and occurrence of tumor-associated acromegaly is pretty much anecdotal .
Lexicon markets Xermelo (teloristat ethyl) for the treatment of carcinoid syndrome
diarrhoea in the United States and has licensed Xermelo to Ipsen Pharma SA for commercialisation in territories outside of the United States and Japan.
The product is intended for the treatment of carcinoid syndrome
diarrhoea in combination with somatostatin analogue therapy in adults inadequately controlled by SSA therapy.
Maximum CgA concentrations were detected in patients with NETs of the stomach and lung, and the highest median CgA values were found in patients with tumors of the small intestine, large intestine, and pancreas, particularly in patients with liver metastases and carcinoid syndrome
. Chou et al, (13) in their study of 44 gastroenteropancreatic-NET and 26 healthy subjects reported a sensitivity of 86% and a specificity of 88%.
Hormone and vasoactive amine secretion from the carcinoid tumour cells cause carcinoid syndrome
. Serotonin, tachykinins, prostaglandins and histamine are the main secretions of carcinoids.
Sandostatin LAR is indicated for acromegaly and severe diarrhea associated with carcinoid syndrome
. It will face generic competition from several generic makers, including Teva, Sun Pharmaceutical Industries Ltd., Sagent Pharmaceuticals Inc.
(2,19) Carcinoid syndrome
, present in approximately 10% of carcinoid tumors, can be seen with metastases to the liver, lung, or other sites which venous drainage bypass the portal circulation (e.g., gonads, diaphragm, osseous sites, etc.).
Based on several under-cut-off values of 5-HIAA and negative scintigraphic scan for somatostatin receptors we also ruled out carcinoid syndrome