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Question

Please may I have some information about carcinoid syndrome?

Answer

Carcinoid syndrome describes symptoms of flushing, cyanosis, abdominal cramps, diarrhoea and problems with the heart valves. It is usually caused by secondary (metastatic) tumours, called carcinoid tumours, which secrete excessive amounts of substances which cause dilation of the blood vessels.

Carcinoid tumours are usually associated with malignant tumours of the ileum which produce serotonin, but can occur with tumours elsewhere in the gastrointestinal system. They can also occur in association with tumours of the lung, pancreas or genital system.

The syndrome does not normally occur unless there are liver secondaries arising from the primary intestinal tumour.

The most common and earliest sign is uncomfortable skin flushing, usually of the head and neck. This can be precipitated by emotion or eating, hot water or alcohol.

Abdominal cramps with diarrhoea are common, and often the main complaint.

Many patients develop right-sided heart problems.

Carcinoid tumours of the lung can be cured by surgery. However, those arising from secondaries to the liver cannot be surgically removed, and radiotherapy is not successful. In spite of this, ten to 15 year survival is not uncommon.

Symptoms are treated as they arise.

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