Carcinoid tumour


Pathology:                    Tumourof enterochromaffin cells of neural crest secreting 5-hydroxytriptamine

                                          Location: Appendix (45%), ileum (30%), rectum(20%), ovary/testis (5%)

                                                               80% tumours >2cmmetastasize


Aetiology:                    Commonestneuroendocrine tumour.

 Peak age >30 years


Symptoms:                  Abdominal pain, diarrhoea, wheeze


Signs:                              Flushing,right-sided heart valve disease, peripheral oedema


Investigations:          Urine: 24 hour collection for 5-hyroxyindoleaceticacid

                                          Imaging: CT/MRI to locate tumour


Treatment:                  Medical: Ocreotide (blocks tumourmediators and reduces peripheral effects)

    and 5-HTantagonists

Surgical: Resectionof tumour, chemotherapy


Complications:         Heart failure, livermetastasis


Prognosis:                    5 year survival – 95% forlocal disease

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