Carcinoid tumour

Giuffre G, Mormandi F, Barresi V, Bordi C, Tuccari G, Barresi G (2006) Quantity of AgNOR in gastric endocrine carcinoid tumours as a potential prognostic tool. Eur J Histochem... 

Dilger JA, Rho EH, Que FG, Sprung J. Octreotide-induced bradycardia and heart block during surgical resection of a carcinoid tumour. Anesth Analg 2004 98 318-20. 

R13. Ronnblom, L. E., Aim, G. V., and Oberg, K. E., Possible induction of systemic lupus erythematosus by interferon-alpha treatment in a patient with a malignant carcinoid tumour. J. Intern. Med. 27, 207-210 (1990). 

Serotonin (5-hydroxytryptamine, 5-HT) is synthesised in enterochromaffin cells, largely in the gut, and also extensively taken up into blood platelets from which it is released to have vascular effects. It has complex effects on the cardiovascular system, varying with the vascular bed and its physiological state it generally constricts arterioles and veins and induces blood platelet aggregation it stimulates intestinal and bronchial smooth muscle. Carcinoid tumours secrete serotonin and symptoms may be benefited by serotonin antagonists, e.g. cyproheptadine, methysergide and sometimes by octreotide (see Index). It is a neurotransmitter in the brain. 

Diarrhoea results from an imbalance between secretion and reabsorption of fluid and electrolytes it has numerous causes, including infections with enteric organisms (which may stimulate secretion or damage absorption), inflammatory bowel disease and nutrient malabsorption due to disease. It also commonly occurs as a manifestation of disordered gut motility in the absence of demonstrable disease (see below). Rarely it is due to secretory tumours of the alimentary tract, e.g. carcinoid tumour or vipoma (a tumour which secretes VIP, vasoactive intestinal peptide). 

Octreotide, a synthetic peptide which shares amino acid homology with somatostatin (see p. 710), inhibits the release of peptides that mediate certain alimentary secretions, and may be used to relieve diarrhoea due to carcinoid tumours and vipomas. 

Nave, H., Mossinger, E., Feist, H., Lang, H., Raab, H.R. Surgery as primary treatment in patients with liver metastases from carcinoid tumours a retrospective, unicentric study over 13 years. Surgery 2001 129 170-175... 

Interferon alfa 2b (interferon alfa-2b [usan] Alferon Intron A Viraferon Sch 30500) is a recombinant (rbe) version, and is extensively used by injection as an anticancer agent to treat hairy cell leukaemia, condylomata acuminata, AIDS-related Kaposi s sarcoma, follicular lymphoma, chronic myelogenous leukaemia, lymph or liver metastases of carcinoid tumour, as an anticancer adjunct in malignant melanoma also, in the maintenance of remission in multiple myeloma chronic active hepatitis B, chronic hepatitis C. 

Caplin ME, Buscombe JR, Hilson AJ, Jones AL, Watkinson AE, Burroughs AK. Carcinoid tumour. Lancet 1998 352 799-805. 

Williams ED, Sandler M. The classification of carcinoid tumours. Lancet. 1963 1 238-239. 

Zarkovic A, Masters J, Carpenter L. Primary carcinoid tumour of the prostate. Pathology. 2005 37 184. 

Carcinoid tumours are found in the gastrointestinal tract, most frcc uently in the appendix and ileocaecal regions. They... 

Ectopic ACTH production from carcinoid tumours is a well-recogniz.cd cause of Cushing s syndrome. 

Some patients with carcinoid tumours develop flushing and diarrhoea, most probably due to an overproduction of serotonin. 

The vasoconstrictor action of shed blood tested by perfusion of the rabbit ear is markedly decreased by heparin and this was known long before the identification of the vasoconstrictor activity as serotonin (5-hydroxytryp-tamine). Heparin inhibits the release of both 5-hydroxytryptamine and a polypeptide from platelets into plasma, and in vitro there is mutual antagonism between heparin and 5-hydroxytryptamine . Heparin effectively antagonizes the effect of serotonin on pulmonary vascular bed and bronchial wall musculature and prevents the symptoms of 5-HT release in pulmonary embolism, in the cardiopulmonary by-pass, in experimental burn injuries and in carcinoid tumour. 

A chemical, 5-hydroxy tryptamine (5-HT), present in platelets, gastro intestinal mucosa, mast cells, and carcinoid tumours. It is a potent vasoconstrictor and also a neurotransmitter in the CNS, and is important in sleep-walking cycles. 

Modlin IM, PavelM, Kidd M, Gustafsson BI. Review article somatostatin analogues in the treatment of gastroenteropancreatic neuroendocrine (carcinoid) tumours. Aliment Pharmacol Ther 2010 31(2) 169-88. 

Extracellular superoxide dismutase mRNA expression was demonstrated in the alveolar macrophages of four patients undergoing surgical resections for carcinoma and carcinoid tumour, respectively (Su et al. 1997). 

Niacin requirements are also affected by diseases or conditions interfering with niacin absorption and/or processing, such as prolonged diarrhoea, chronic dialysis treatment, chronic colitis (particularly ulcerative colitis), cirrhosis of the liver, tuberculosis of the gastrointestinal tract, malignant carcinoid tumour and chronic alcoholism (Food and Nutrition Board 1998). Substantial individual differences (about 30%) in the conversion efficiency of tryptophan to niacin have been reported (Horwitt et al. 1981). 

Sandler, M. and Snow, P. J. D., An atypical carcinoid tumour secreting 5-hydroxytryptophan, Lancet, 1958 p. 137. 

Thorson, A., Hanson, A., Pernow, B., Soderstr5m. N., Waldenstrom, J., Winblad, S. and WuLFF, H. B., Carcinoid tumour within an ovarian teratoma in a patient with the carcinoid syndrome (carcinoidosis), Acta med, scand, 161, 495 (1958). 

Mustala, O. O. and Airaksinen, M. M., Excretion of histamine and metabolites of 5-hydroxytryptamine in a case of metastasized carcinoid tumour, Acta med. scand. 171, 483 (1962). 

Halonen, P. I., Koskelo, P., Frick, M. H. and Merenmies, L., Metastatic carcinoid tumour associated with complicated silicosis, Acta med. scand. 171, 477 (1962). 

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