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Carcinoid tumor

Last revised by Mohammad Niknejad ◉ on 10 Dec 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Niknejad M, Hartung M, et al. Carcinoid tumor. Reference article, Radiopaedia.org (Accessed on 17 Jan 2025) https://doi.org/10.53347/rID-9528

DOI:

https://doi.org/10.53347/rID-9528

Permalink:

https://radiopaedia.org/articles/9528

rID:

9528

Article created:

27 Apr 2010, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

10 Dec 2024, Mohammad Niknejad ◉

Disclosures:

At the time the article was last revised Mohammad Niknejad had no financial relationships to ineligible companies to disclose.

View Mohammad Niknejad's current disclosures

Revisions:

61 times, by 31 contributors - see full revision history and disclosures

Systems:

Chest, Gastrointestinal, Oncology

Synonyms:

Carcinoid tumour general
Carcnoid tumor
Carcinoid tumour (general)
Carcinoid tumors
Carcinoid tumours
Carcinoids

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

Pathology

Most carcinoid tumors histologically arise from enterochromaffin (Kulchitsky) cells in Lieberkuhn crypts. They more often originate from the distal part of the ileum and produce serotonin ¹⁷.

Location

gastrointestinal tract carcinoid (60-85% of all carcinoids) ^11,12
- small bowel: ~40% of gastrointestinal carcinoids, mostly in the terminal ileum
- rectum (~23%)
- colon (~15%)
- appendix (~10%)
- stomach (~8%)
- pancreas (~8%)
carcinoid tumors of the lung (~25% of all carcinoids)
- bronchial carcinoid
- peripheral pulmonary carcinoid tumors
primary hepatic carcinoid
ovarian carcinoid: accounts for 0.5% of carcinoid tumors and 0.3% of ovarian tumors ⁷
thymic carcinoid

Markers

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

Radiographic features

CT/MRI

Refer to specific articles (above) for imaging characteristics.

Nuclear medicine

gallium-68 octreotide PET-CT (e.g. Ga-68 DOTATATE) has shown improved accuracy for detection of neuroendocrine tumors relative to indium-111 pentetreotide (Octreoscan) SPECT/CT ^13,14
indium-111 octreotide (e.g. Octreoscan) SPECT-CT ¹⁵
iodine-123 MIBG will also concentrate on carcinoid tumors, including the low percentage (~15%) that are negative with indium-111 octreotide ¹⁶

Treatment and prognosis

Complications

cardiac valve lesions from carcinoid

History and etymology

It was initially coined by Oberndorfer in 1907 as “karzinoide” to denote its resemblance to carcinoma ⁴.

Quiz questions

References

1. Binstock A, Johnson C, Stephens D, Lloyd R, Fletcher J. Carcinoid Tumors of the Stomach: A Clinical and Radiographic Study. AJR Am J Roentgenol. 2001;176(4):947-51. doi:10.2214/ajr.176.4.1760947 - Pubmed
2. Picus D, Glazer H, Levitt R, Husband J. Computed Tomography of Abdominal Carcinoid Tumors. AJR Am J Roentgenol. 1984;143(3):581-4. doi:10.2214/ajr.143.3.581 - Pubmed
3. Janson E, 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. doi:10.1023/a:1008215730767 - Pubmed
4. Rosado de Christenson M, Abbott G, Kirejczyk W, Galvin J, Travis W. Thoracic Carcinoids: Radiologic-Pathologic Correlation. Radiographics. 1999;19(3):707-36. doi:10.1148/radiographics.19.3.g99ma11707 - Pubmed
5. Horton K, Kamel I, Hofmann L, Fishman E. Carcinoid Tumors of the Small Bowel: A Multitechnique Imaging Approach. AJR Am J Roentgenol. 2004;182(3):559-67. doi:10.2214/ajr.182.3.1820559 - Pubmed
6. Hendy G, Bevan S, Mattei M, Mouland A. Chromogranin A. Clin Invest Med. 1995;18(1):47-65. - Pubmed
7. Shanbhogue A, Shanbhogue D, Prasad S, Surabhi V, Fasih N, Menias C. Clinical Syndromes Associated with Ovarian Neoplasms: A Comprehensive Review. Radiographics. 2010;30(4):903-19. doi:10.1148/rg.304095745 - Pubmed
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. 2006;13(2):67-76. PMC1891174 - Pubmed
9. Vincent T. DeVita. DeVita, Hellman, and Rosenberg's Cancer : Principles & Practice of Oncology - 9. Ed. (2011) ISBN: 9781451105452 - Google Books
10. Richard N. Mitchell, Vinay Kumar, Abul K. Abbas et al. Pocket Companion to Robbins and Cotran Pathologic Basis of Disease. (2011) ISBN: 9781416054542 - Google Books
11. Modlin I, Moss S, Oberg K et al. Gastrointestinal Neuroendocrine (Carcinoid) Tumours: Current Diagnosis and Management. Med J Aust. 2010;193(1):46-52. doi:10.5694/j.1326-5377.2010.tb03742.x - Pubmed
12. Strosberg J, Nasir A, Hodul P, Kvols L. Biology and Treatment of Metastatic Gastrointestinal Neuroendocrine Tumors. Gastrointest Cancer Res. 2008;2(3):113-25. PMC2633071 - Pubmed
13. Deppen S, Liu E, Blume J et al. Safety and Efficacy of 68Ga-DOTATATE PET/CT for Diagnosis, Staging, and Treatment Management of Neuroendocrine Tumors. J Nucl Med. 2016;57(5):708-14. doi:10.2967/jnumed.115.163865 - Pubmed
14. Antunes P, Ginj M, Zhang H et al. Are Radiogallium-Labelled DOTA-Conjugated Somatostatin Analogues Superior to Those Labelled with Other Radiometals? Eur J Nucl Med Mol Imaging. 2007;34(7):982-93. doi:10.1007/s00259-006-0317-x - Pubmed
15. Kaltsas G, Mukherjee J, Grossman A. The Value of Radiolabelled MIBG and Octreotide in the Diagnosis and Management of Neuroendocrine Tumours. Ann Oncol. 2001;12 Suppl 2:S47-50. doi:10.1093/annonc/12.suppl_2.s47 - Pubmed
16. 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. 2006;13(2):67-76. PMC1891174 - Pubmed
17. Bonekamp D, Raman S, Horton K, Fishman E. Role of Computed Tomography Angiography in Detection and Staging of Small Bowel Carcinoid Tumors. World J Radiol. 2015;7(9):220-35. doi:10.4329/wjr.v7.i9.220 - Pubmed

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