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Malignant carcinoid tumors. An analysis of 103 patients with regard to tumor localization, hormone production, and survival.

Abstract
In a prospective study of 103 patients with carcinoid tumors consecutively referred for medical treatment, the most common sites of the primary tumors were the ileum (73%), bronchi (7%), and jejunum (4%). All patients had local metastases, and 96 (93%) also had liver metastases. The most common initial symptoms were diarrhea (32%), ileus (25%), and flush (23%). The overall frequency of diarrhea was 84% and of flush was 75%. Heart insufficiency caused by cardiac valve disease was seen in 33% of the patients. The carcinoid syndrome, including flush, diarrhea, and elevated urinary 5-hydroxyindole acetic acid (5-HIAA) concentrations, was manifested by 69 patients (67%), 64 of whom (93%) had carcinoid tumors of mid-gut origin. Elevated urinary 5-HIAA was found in 91 patients (88%), of which 89 displayed liver metastases. The plasma concentration of the tachykinin neuropeptide K (NPK) was elevated in 67 patients (66%), 63 of whom had tumors of the mid-gut region. Serum pancreatic polypeptide (PP) and human chorionic gonadotrophin alpha levels were elevated in 43% and 28% of the patients, respectively, and the highest levels were found in patients with metastatic bronchial carcinoid tumors. Thirty-nine of the 103 patients are now dead; 18 died of tumor progression, whereas 14 patients died of heart failure secondary to a carcinoid tricuspidal valve insufficiency. The estimated median survival from the time of histologic diagnosis was 14 years, and from the time of carcinoid syndrome was 8 years.
AuthorsI Norheim, K Oberg, E Theodorsson-Norheim, P G Lindgren, G Lundqvist, A Magnusson, L Wide, E Wilander
JournalAnnals of surgery (Ann Surg) Vol. 206 Issue 2 Pg. 115-25 (Aug 1987) ISSN: 0003-4932 [Print] United States
PMID2440390 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Neuropeptides
  • Tachykinins
  • neuropeptide K
  • Hydroxyindoleacetic Acid
Topics
  • Adult
  • Aged
  • Bronchial Neoplasms (pathology)
  • Diarrhea (complications)
  • Female
  • Flushing (complications)
  • Gastrointestinal Neoplasms (pathology)
  • Heart Arrest (complications)
  • Humans
  • Hydroxyindoleacetic Acid (urine)
  • Male
  • Malignant Carcinoid Syndrome (complications, diagnostic imaging, pathology, urine)
  • Middle Aged
  • Neuropeptides (metabolism)
  • Prospective Studies
  • Tachykinins
  • Tomography, X-Ray Computed

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