Complete histological regression of metastatic carcinoid tumour after treatment with octreotide.
A 69-year-old woman was admitted with facial flushing, weight loss and intermittent diarrhoea. Urinary 5-hydroxyindole-acetic acid (5-HIAA) level was elevated at 200 micromol/24 h (normal: < 50). Computerized tomography (CT) demonstrated multiple enhancing liver metastases with biopsy proven carcinoid metastases with no evidence of primary tumour at this stage. Octreotide was initiated, resulting in marked improvement in carcinoid symptoms. Nine years later, she presented with abdominal pain and slightly deranged liver function tests. Repeat colonoscopy at this stage, showed an ileal tumour causing impending obstruction, necessitating urgent right hemicolectomy. Histology demonstrated primary carcinoid tumour. She continued on octreotide. Three years later at the age of 81 years, she suffered a fatal haemorrhagic stroke. Autopsy revealed complete regression of hepatic carcinoid metastases.
Imtiaz
K E
KE
Depatment of Endocrinology, Halton General Hospital, Runcorn, UK. komimtiaz@hotmail.com
Monteith
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P
Khaleeli
A
A
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D003082:Colectomy; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D015282:Octreotide / Q000627:therapeutic use*; D020521:Stroke / Q000150:complications
D018931:Antineoplastic Agents, Hormonal; D015282:Octreotide