A stepwise approach to the management of metastatic midgut carcinoid tumor.

Abstract

BACKGROUND:

A 48-year-old man presented with diarrhea, flushing, abdominal pain and weight loss of 10 kg over a 6-month period. He subsequently developed dyspnea on exertion.

INVESTIGATIONS:

Physical examination, laboratory tests, CT of the abdomen, liver biopsy, echocardiography, immunohistochemistry staining of the biopsy specimen for neuroendocrine markers including chromogranin A, synaptophysin and protein gene product 9.5, and (111)In-pentetreotide scintigraphy (Octreoscan).

DIAGNOSIS:

Carcinoid tumor of midgut origin with large segment 3 liver metastasis. Carcinoid syndrome and carcinoid heart disease.

MANAGEMENT:

Symptomatic relief with somatostatin analog therapy and subsequent resection of the segment 3 liver metastasis. Tricuspid and pulmonary valve replacement.

• Authors: Sanjeev Bhattacharyya, Dorothy M Gujral, Christos Toumpanakis, Gilles Dreyfus, Brian R Davidson, Joseph Davar, Martyn E Caplin
• Journal: Nature reviews. Clinical oncology (Nat Rev Clin Oncol) Vol. 6 Issue 7 Pg. 429-33 (Jul 2009) ISSN: 1759-4782 [Electronic] England
• PMID: 19561636 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Delayed-Action Preparations
• Somatostatin

Topics

• Antineoplastic Agents (therapeutic use)
• Carcinoid Heart Disease (therapy)
• Carcinoid Tumor (pathology, therapy)
• Chemoembolization, Therapeutic
• Combined Modality Therapy
• Delayed-Action Preparations
• Humans
• Intestinal Neoplasms (secondary, therapy)
• Liver Neoplasms (secondary, therapy)
• Male
• Middle Aged
• Somatostatin (analogs & derivatives, therapeutic use)