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Carcinoid tumours

Dr Yuranga Weerakkody et al.

A carcinoid tumour is a type of neuroendocrine tumour which can occur in number of locations. Carcinoid tumours arise from endocrine amine precursor uptake and decarboxylation (APUD) cells that can be found throughout the gastrointestinal tract as well as other organs (e.g. lung). In general they are slow growing tumours but are nevertheless capable of metastasis.

Clinical presentation

gastrointestinal tract carcinoid can present as vague abdominal pain.
carcinoid syndrome

Pathology

Location

gastrointestinal tract carcinoid - the gastrointestinal tract accounts for ~ 85% carcinoid tumours while carcinoid accounts for ~ 2% of gastrointestinal tract tumours.
- appendiceal carcinoid - the appendix accounts for ~ 50% of all carcinoid tumours
- small bowel carcinoid - the terminal ileum accounts for ~ 90% of all small bowel carcinoid tumours
- gastric carcinoid - carcinoid accounts for 0.3% of gastric tumours ¹
primary hepatic carcinoid :
ovarian carcinoid - accounts for 0.5% of carcinoid tumours and 0.3 % of ovarian tumours ⁷.
carcinoid tumours of lung
- bronchial carcinoid - accounts for 1-2% of lung tumours ⁴
- peripheral pulmonary carcinoid tumours
thymic carcinoid

Serological markers

5HIAA - (5-hydroxyindoleaceticacid) : usually suggests functioning carcinoid tumour
chromogranin A (CgA) - considered valuable tool in the diagnosis of neuroendocrine neoplasia in general ⁶

Radiographic features

CT/MRI

Refer to specific articles for imaging characteristics

Scintigraphy

In¹¹¹ octreotide (Octreoscan) - generally specific for GI tract carcinoid tumours as well as liver metastases

Etymology

Initially coined by Oberndorfer in 1907 as “Karzinoide” to denote its resemblance to carcinoma ⁴

Complications

cardiac valve lesions from carcinoid

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