Complications of midgut carcinoid tumors and carcinoid syndrome.
The carcinoid syndrome, associated with carcinoid tumors of the midgut, consists of symptoms such as diarrhea, flushing, wheezing and cardiovascular symptoms. This review focuses on these symptoms and discusses therapeutic options. The symptoms are caused by the secretion of biogenic amines, polypeptides and other factors of which serotonin is the most prominent. However, diarrhea is also due to factors such as malabsorption. Besides antitumor therapy, more specific interventions such as serotonin receptor blockers can be useful. The carcinoid heart disease involves the tricuspid and pulmonary valve. In the pathogenesis, serotonin plays a central role. The therapeutic approach is mostly symptomatic. Other cardiovascular complications include bowel ischemia and hypertension. Pellagra and psychiatric symptoms are due to a depletion of tryptophan, which is consumed by the carcinoid tumor for serotonin synthesis. Finally, follow-up and clinical practice of patients with carcinoid tumors are discussed.
Department of Medical Oncology, University Hospital Groningen, Groningen, The Netherlands.
Anouk N A
AN
van der Horst-Schrivers
A N Machteld
AN
Wymenga
Thera P
TP
Links
Pax H B
PH
Willemse
Ido P
IP
Kema
Elisabeth G E
EG
de Vries
D002275:Carcinoid Heart Disease / Q000150:complications; D002276:Carcinoid Tumor / Q000150:complications* / Q000628:therapy; D003967:Diarrhea / Q000209:etiology; D005483:Flushing / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008303:Malignant Carcinoid Syndrome / Q000150:complications* / Q000628:therapy; D001523:Mental Disorders / Q000209:etiology; D008954:Models, Biological; D010383:Pellagra / Q000209:etiology; D012135:Respiratory Sounds / Q000209:etiology; D012701:Serotonin / Q000378:metabolism; D013274:Stomach Neoplasms / Q000150:complications* / Q000628:therapy
D012701:Serotonin