Carcinoid syndrome

Question 1

Carcinoid syndrome
usually occurs when

Answer 1

metastases are present in the liver and release serotonin into the systemic circulation

may also occur with lung carcinoid as mediators are not ‘cleared’ by the liver

Question 2

features of carcinoid tumor ?

Answer 2

flushing (often the earliest symptom)

diarrhoea

bronchospasm

hypotension

right heart valvular stenosis (left heart can be affected in bronchial carcinoid) = The valvular effects are tricuspid insufficiency and pulmonary stenosis

pellagra

Question 3

other molecules such as what can be released in carcinoid tutors ?

Answer 3

ACTH and GHRH may also be secreted resulting in, for example, Cushing’s syndrome

Question 4

investigations for carcinoid tutors ?

Answer 4

urinary 5-HIAA
plasma chromogranin A y

Question 5

Management

Answer 5

somatostatin analogues e.g. octreotide

diarrhoea: cyproheptadine may help