Carcinoid Syndrome

by Carlo Raj, MD

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    Our topic brings us to Carcinoid Syndrome. Here once again, I want to make sure that I clarify any doubt that you might have about carcinoid tumor, syndrome or bronchial carcinoid. Let's begin. Tumors arising from entero– chromaffin like cells. Stop there. Entero–chromaffin, hmm, that sounds rather endocrine in nature. That's exactly right. So therefore anytime you find anything with carcinoid, please understand that you're going to produce all these interesting peptides. And I say interesting because there are approximately 40 of them. Of all the 40 or so, you'll be paying attention to serotonin. The syndrome of watery diarrhea, flushing, bronchospasm, right heart failure, that's the syndrome of versus tumor. So what happenned and that was, aren't you seeing the same thing? No. Carcinoid tumor will be located in the intestine. It does not metastasize. By golly though, it is then going to produce all these various peptides including serotonin. So you really, you don't have any clinical manifestation of carcinoid tumor. Because these chemicals enter the portal vein, enter the liver; because the liver is not damaged and there is no metastasis, the liver can handle everything that's coming from the intestine so there is no flushing, no right–sided valvular heart disease and definitely no bronchospasms. But with carcinoid syndrome, quite different. So what happens in carcinoid syndrome? It's a fact that you have an entero–chromaffin tumor that has now metastasized from the intestine, has now colonized the liver, behaves exactly like a carcinoid tumor but now you're in the liver. Now you have to call this syndrome. All those chemicals, peptides, will exit the liver because the liver will not have a chance to neutralize and detoxify, maybe a few but not much. Will enter the hepatic vein, inferior vena cava, where you're going to enter? Right...

    About the Lecture

    The lecture Carcinoid Syndrome by Carlo Raj, MD is from the course Small and Large Intestine Diseases.

    Included Quiz Questions

    1. Enterochromaffin cells
    2. PP cells
    3. Schwann cells
    4. Beta cells of islets of pancreas
    5. Ganglion cells
    1. 5-HIAA
    2. Insulin
    3. Glucagon
    4. Epinephrine
    5. Inhibin
    1. Tryptophan
    2. Tyrosine
    3. Threonine
    4. Methionine
    5. Lysine
    1. Carcinoid syndrome is only seen in the gastrointestinal tract.
    2. The active metabolites produced by carcinoid tumor is detoxified in the liver preventing the manifestation of symptoms.
    3. Carcinoid syndrome can produce flushing and watery diarrhea.
    4. Urinary levels of 5-HIAA is high in carcinoid syndrome.
    5. Symptoms suggests to metastasis to the liver from carcinoid tumor.

    Author of lecture Carcinoid Syndrome

     Carlo Raj, MD

    Carlo Raj, MD

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