Carcinoid Tumour

The majority of carcinoids caused by hypergastrinemia occur in association with either pernicious anemia (75%) or Zollinger-Ellison syndrome (5%). Carcinoids associated with Zollinger-Ellison syndrome occur almost exclusively in patients with MEN 1, in which loss of 11q13 has been reported. Carcinoids caused by hypergastrinemia tend to be multicentric, less than 1 cm in size, and have a low potential for metastatic spread or development of carcinoid syndrome. Small lesions may be successfully treated with endoscopic resection followed by periodic endoscopic surveillance. Antrectomy reduces serum gastrin levels and may lead to regression of small tumors. Patients with large or multiple carcinoids should undergo surgical tumor resection.

A carcinoid tumour, sometimes referred to as simply carcinoid, is a tumour of the neuroendocrine system. The neuroendocrine system is a network of glands that produce particular hormones and send them into the bloodstream to affect the function of different organs in the body. Carcinoid tumours describe a range of neoplasms arising from neuroendocrine cells or their precursors. Of intestinal carcinoids, the most common sites are in the midgut, especially the appendix and terminal ileum. Carcinoid tumors act like the cells they come from. They often release certain hormone-like substances into the bloodstream. In about 10% of people, the carcinoid tumors spread and grow very large and release high amounts of those hormones.Carcinoid tumours often grow slowly and it may be several years before any symptoms appear and the tumour is diagnosed.

Most tumors in the intestinal tract come from different glandular cells (the kind of gland cell that produce mucus rather than hormones) of the inner lining of the digestive system. These can be either adenomas (benign) or adenocarcinomas (malignant). Like most cells of the body, gastrointestinal system neuroendocrine cells sometimes undergo certain changes that cause them to grow too much and form tumors.The carcinoid syndrome develops when products, chiefly serotonin, are released by the tumour in large amounts and escape hepatic degradation. Carcinoid tumours are rare neuroendocrine lesions Arise from amine precursor uptake and decarboxylation (APUD) cells Approximately 1,000 are identified in the United Kingdom each year .

Cause of Carcinoid Tumour

Some causes of Carcinoid Tumour :

• Carcinoid Tumour is a rare type of tumour. Approximately 1200 new carcinoid tumours are diagnosed each year in the UK.
• Men and women are affected equally and carcinoid is usually found in adults over the age of 30. As with many other forms of cancer, the exact cause is unknown.

Symptoms of Carcinoid Tumour

Here are some common symptoms of Carcinoid Tumour

• The type of symptoms will depend on where the tumour started, where it may have spread to, and whether it produces a hormone known as serotonin.
• If a carcinoid tumour starts in the appendix it does not usually spread to other parts of the body and does not produce serotonin.
• As a result there are very few symptoms and it is often discovered by chance when the appendix is removed for another reason.
• Flushing
• Diarrhea
• Arthritis
• Peripheral edema
• Wheezing
• Heart valvular lesions
• Cramping
• Pellagra

Treatment of Carcinoid Tumour

Some treatment of Carcinoid Tumour :

• Diagnosis is often made after resection of primary tumour
• Liver metastases are rarely amenable to hepatic resection
• Conventional chemotherapy has poor response rate
• Carcinoid syndrome can be treated with drugs known as somatostatin analogues. These work by reducing the production of hormones by the tumour, and can help to reduce the flushing and diarrhoea .
• The somatostatin analogue octreotide (Sandostatin®) is given as a short-acting injection under the skin up to three times a day. Most people are taught how to give the injection themselves.
• The treatment for a carcinoid tumour depends on a number of factors including your general health and the size and position of the tumour.
• The results of your tests will enable your doctor to discuss the best type of treatment with you.

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