Carcinoid tumors are a type of neuroendocrine tumor that can occur in a number of locations. Carcinoid tumors 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 tumors but are nevertheless capable of metastasizing.
- can be variable, dependent on the location:
- carcinoid tumors involving the jejunum and ileum can be large at presentation but are usually found incidentally
- rectal carcinoids may cause pain
- gastrointestinal tract carcinoid can present as vague abdominal pain
-
carcinoid syndrome: in 8% of patients with a carcinoid tumor 9
Location
Markers
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5-HIAA (5-hydroxyindoleacetic acid): usually suggests a functioning carcinoid tumor
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chromogranin A (CgA): considered a valuable tool in the diagnosis of neuroendocrine neoplasia in general 6
CT/MRI
Refer to specific articles (above) for imaging characteristics.
Nuclear medicine
- indium-111 octreotide (Octreoscan) will concentrate in gastrointestinal tract carcinoid tumors as well as in liver metastases, and is generally considered the test of choice due to its high sensitivity 14
- iodine-123 MIBG will also concentrate in carcinoid tumors, including the low percentage (~15%) that are negative with indium-111 octreotide 13
- gallium-68 octreotide PET scan: usually avid
Treatment and prognosis
Complications
History and etymology
It was initially coined by Oberndorfer in 1907 as “karzinoide” to denote its resemblance to carcinoma 4.
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- 14. Kaltsas GA, Mukherjee JJ, Grossman AB. The value of radiolabelled MIBG and octreotide in the diagnosis and management of neuroendocrine tumours. Ann. Oncol. 2002;12 Suppl 2: S47-50. Pubmed citation
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