Carcinoid syndrome history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Patients with carcinoid syndrome may present with a history of flushing of the skin, abdominal cramps, diarrhea, tricuspid insufficency, pulmonic stenosis, and bronchoconstriction.

Symptoms

Most carcinoids are asymptomatic through the natural lifetime and are discovered only upon surgery for unrelated reasons; these are called coincidental carcinoids. But all carcinoids are considered to have malignant potential.

About 10 percent of carcinoids secrete excessive levels of a range of hormones, most notably serotonin (5-HT), causing:

• Flushing
• Diarrhea
• Wheezing
• Abdominal cramping
• Peripheral edema

This constellation of symptoms is called carcinoid syndrome or (if acute) carcinoid crisis. Occasionally, haemorrhage or the effects of tumour bulk are the presenting symptoms.

Lung Carcinoid Tumor

• Post-obstructive pneumonia
• Wheezing
• Cough

Thymic Carcinoids

Approximately 40% of patients with thymic carcinoid have Cushing syndrome as a result of adrenocorticotropic hormone secretion by the tumor.

Carcinoid Heart Disease

Carcinoid heart disease develops in more than one-third of patients with carcinoid syndrome. Symptoms include:

• Tricuspid and pulmonic regurgitation
• Pulmonary stenosis
• Mitral and aortic insufficiency
• Cardiac dysrhythmias

References

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