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 metastasising.
- 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
- gastrointestinal tract carcinoid (60-85% of all carcinoids) 11,12
- carcinoid tumors of the lung (~25% of all carcinoids)
- primary hepatic carcinoid
- ovarian carcinoid: accounts for 0.5% of carcinoid tumors and 0.3% of ovarian tumors 7
- thymic carcinoid
- 5-HIAA (5-hydroxyindoleacetic acid): usually suggests a functioning carcinoid tumor
- chromogranin A (CgA): considered a valuable tool in the diagnosis of neuroendocrine neoplasia in general 6
Refer to specific articles (above) for imaging characteristics.
111In-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.
123I-MIBG will also concentrate in carcinoid tumors, including the low percentage (~15%) that are negative with 111In-octreotide 13.
68Ga-octreotide PET scan: usually avid
Treatment and prognosis
History and etymology
It was initially coined by Oberndorfer in 1907 as “Karzinoide” to denote its resemblance to carcinoma 4.
- 1. Binstock AJ, Johnson CD, Stephens DH et-al. Carcinoid tumors of the stomach: a clinical and radiographic study. AJR Am J Roentgenol. 2001;176 (4): 947-51. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Picus D, Glazer HS, Levitt RG et-al. Computed tomography of abdominal carcinoid tumors. AJR Am J Roentgenol. 1984;143 (3): 581-4. AJR Am J Roentgenol (abstract) - Pubmed citation
- 3. Janson ET, Holmberg L, Stridsberg M et-al. Carcinoid tumors: analysis of prognostic factors and survival in 301 patients from a referral center. Ann. Oncol. 1997;8 (7): 685-90. Ann. Oncol. (abstract) - Pubmed citation
- 4. Rosado de christenson ML, Abbott GF, Kirejczyk WM et-al. Thoracic carcinoids: radiologic-pathologic correlation. Radiographics. 19 (3): 707-36. Radiographics (full text) - Pubmed citation
- 5. Horton KM, Kamel I, Hofmann L et-al. Carcinoid tumors of the small bowel: a multitechnique imaging approach. AJR Am J Roentgenol. 2004;182 (3): 559-67. AJR Am J Roentgenol (full text) - Pubmed citation
- 6. Hendy GN, Bevan S, Mattei MG et-al. Chromogranin A. Clin Invest Med. 1995;18 (1): 47-65. - Pubmed citation
- 7. Shanbhogue AK, Shanbhogue DK, Prasad SR et-al. Clinical syndromes associated with ovarian neoplasms: a comprehensive review. Radiographics. 30 (4): 903-19. doi:10.1148/rg.304095745 - Pubmed citation
- 8. Maroun J, Kocha W, Kvols L et-al. Guidelines for the diagnosis and management of carcinoid tumours. Part 1: the gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group. Curr Oncol. 2010;13 (2): 67-76. Free text at pubmed - Pubmed citation
- 9. DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology. LWW. ISBN:1451105452. Read it at Google Books - Find it at Amazon
- 10. Pocket Companion to Robbins & Cotran Pathologic Basis of Disease, 8th Edition. Saunders. ISBN:1416054545. Read it at Google Books - Find it at Amazon
- 11. Modlin IM, Moss SF, Oberg K et-al. Gastrointestinal neuroendocrine (carcinoid) tumours: current diagnosis and management. Med. J. Aust. 2010;193 (1): 46-52. Pubmed citation
- 12. Strosberg JR, Nasir A, Hodul P et-al. Biology and treatment of metastatic gastrointestinal neuroendocrine tumors. Gastrointest Cancer Res. 2011;2 (3): 113-25. Free text at pubmed - Pubmed citation
- 13. Maroun J, Kocha W, Kvols L et-al. Guidelines for the diagnosis and management of carcinoid tumours. Part 1: the gastrointestinal tract. A statement from a Canadian National Carcinoid Expert Group. Curr Oncol. 2010;13 (2): 67-76. Free text at pubmed - Pubmed citation
- 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