Carcinoid syndrome: Difference between revisions
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Revision as of 23:22, 7 September 2016
Background
- Carcinoid tumors are neuroendocrine malignancies
- Primary tumors can be located in:[1]
- Gastrointestinal tract (55%)
- Bronchopulmonary system (30%)
- Other sites rarer or may actually be metastases (ovary, liver, gallbladder, thymus, middle ear)
- Syndrome results from tumor production of serotonin, histamine, bradykinin, and/or prostaglandin
Clinical Features
- Vasodilation
- Due to increased histamine and kinin production
- Cutaneous flushing
- Hypotension, vasodilatory shock
- Diarrhea
- Bronchospasm
- Cardiac valvular lesions
- Due to serotonin-stimulated fibroblast growth/fibrogenesis
- Can cause tricuspid or pulmonary regurgitation or stenosis, right heart failure
Differential Diagnosis
Evaluation
- Evaluation to rule out other causes of shock, diarrhea, etc.
- 24 hour urinary HIAA (5-hydroxyindoleacetic acid)
- Echocardiography
- Imaging to locate the tumor, if not known
Management
- Treat shock and right heart failure
- Octreotide
- Antihistamines
Disposition
See Also
External Links
References
- ↑ Strosberg, JR. Clinical charecteristis of carcinoid tumors. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on August 20, 2016.)