Materiały źródłowe

• #1 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Carcinoid syndrome is a rare clinical condition caused by metastatic, well-differentiated neuroendocrine tumors, primarily originating in the midgut and associated with liver metastases. These tumors secrete biogenic amines, particularly serotonin, leading to hallmark symptoms such as flushing, diarrhea, bronchospasm, and systemic complications like carcinoid heart disease. Flushing, often triggered by stress, food, or alcohol, and diarrhea, is frequently chronic and debilitating. […] Carcinoid syndrome arises from the release of biologically active amines and peptides into the systemic circulation, bypassing the liver’s first-pass metabolism. The liver normally inactivates these substances, but liver metastases from neuroendocrine tumors can allow these products to enter the circulation and exert systemic effects.

• #2 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Some neuroendocrine tumours (NETs) make large amounts of hormones and proteins. The most common substance they make is serotonin. They sometimes release serotonin and the other proteins into the bloodstream. This can cause a collection of symptoms called carcinoid syndrome. […] Carcinoid syndrome is most common in people with a small bowel NET which has spread to the liver. It can also happen in people with lung and pancreatic NETs. But this is less common. […] The main symptoms of carcinoid syndrome are: […] Flushing of the skin. The skin of your face, neck and chest might look red (flushed). It may also feel warm and itchy. 85 out of every 100 people (85%) with carcinoid syndrome have this symptom. Flushing of the skin is often unexpected and unpredictable. Some people find there are triggers. For example, certain foods, drinking coffee or alcohol, stress or exercise.

• #3 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/about-carcinoid-syndrome

  Some neuroendocrine tumours (NETs) make large amounts of hormones and proteins. The most common substance they make is serotonin. They sometimes release serotonin and the other proteins into the bloodstream. This can cause a collection of symptoms called carcinoid syndrome. […] Carcinoid syndrome is most common in people with a small bowel NET which has spread to the liver. It can also happen in people with lung and pancreatic NETs. But this is less common. […] The main symptoms of carcinoid syndrome are: […] Flushing of the skin. The skin of your face, neck and chest might look red (flushed). It may also feel warm and itchy. 85 out of every 100 people (85%) with carcinoid syndrome have this symptom. Flushing of the skin is often unexpected and unpredictable. Some people find there are triggers. For example, certain foods, drinking coffee or alcohol, stress or exercise.

• #4 Carcinoid Syndrome | UCSF Department of Surgery

  https://surgicaloncology.ucsf.edu/condition/carcinoid-syndrome

  Carcinoid syndrome is a disease defined by a constellation of symptoms, physical manifestations, and abnormal laboratory findings. […] Major symptoms include hot, red facial flushing, diarrhea and wheezing. […] Carcinoid syndrome occurs when the tumor produces excessive amounts of the hormone serotonin in an individual who has liver or ovarian metastases. […] In patients without spread to the liver, the serotonin hormones released by the intestinal tumor will be broken down to inactive substances, effectively destroyed. However, if the tumor has spread to the liver, ovaries, or retroperitoneum and liver enzymes can no longer destroy the excess hormones, they accumulate in the body and cause the debilitating symptoms of carcinoid syndrome. […] Symptoms of carcinoid syndrome are frequently mistaken for other diseases, such as Crohns disease, ulcerative colitis, or irritable bowel syndrome (IBS). […] About 10% of the people with a carcinoid tumor will develop carcinoid syndrome. […] Carcinoid crisis is a life-threatening form of carcinoid syndrome that results where there is an overwhelming release of biologically active compounds such as serotonin from the tumor.

• #5 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Carcinoid-and-Carcinoid-Syndrome.aspx

  The symptoms of this cancer are not visible until it reaches an advanced stage. […] The syndrome occurs only when the carcinoid tumor is in the advanced stage, and its treatment involves addressing the carcinoid tumor. […] The symptoms that are associated with carcinoid syndrome are: Pain in the stomach and diarrhea: There is a frequent occurrence of abdominal cramps along with watery stools (diarrhea) in people with carcinoid syndrome. Loss of appetite can also be considered as a symptom. […] Flushing of the skin: The facial skin and the skin on the upper chest become hot and are transformed into purple color. This type of flushing might occur for few minutes or hours or might extend throughout the day. […] Difficulty in breathing and wheezing: Breathlessness and wheezing are the common symptoms of carcinoid syndrome. These symptoms might occur along with skin flushing.

• #6 Carcinoid Syndrome – NETRF

  https://netrf.org/old-for-patients/living-with-nets/carcinoid-syndrome/

  A high-pitched whistling sound while breathing, which can be associated with difficulty breathing. […] Carcinoid syndrome can develop when a neuroendocrine tumor produces sufficient quantities of substances that cause the symptoms associated with the condition. […] Among those living with NETs, researchers estimate 19% develop carcinoid syndrome. […] Carcinoid syndrome is most commonly caused by NETs that occur in the midgut and spread (metastasize) to the liver; however, in rare instances, carcinoid syndrome may be caused by NETs originating in the foregut and hindgut.

• #7 Carcinoid syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/carcinoid-syndrome/symptoms-causes/syc-20370666

  Carcinoid syndrome occurs when a rare cancerous tumor called a carcinoid tumor secretes certain chemicals into your bloodstream, causing a variety of signs and symptoms. Carcinoid syndrome typically occurs in people who have carcinoid tumors that are advanced. Treatment for carcinoid syndrome usually involves treating the cancer. However, because most carcinoid tumors don’t cause carcinoid syndrome until they’re advanced, a cure may not be possible. Medications may be recommended to relieve your carcinoid syndrome symptoms and make you more comfortable. […] The signs and symptoms of carcinoid syndrome depend on which chemicals the carcinoid tumor secretes into your bloodstream. The most common signs and symptoms include: Skin flushing. The skin on your face and upper chest feels hot and changes color ranging from pink to purple. Flushing episodes may last from a few minutes to a few hours or longer. Flushing may happen for no obvious reason, though sometimes it can be triggered by stress, exercise or drinking alcohol.

• #8 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Flushing is the clinical hallmark of carcinoid syndrome and occurs in 85% of NETs patients who experience symptoms of carcinoid syndrome. Flushing is a sudden, intense reddening of the skin with a warming and/or burning sensation of the face, head, and upper chest. These episodes occur spontaneously and can last anywhere from 30 seconds to 30 minutes, but they can also be provoked by eating, drinking alcohol, coffee, spices, or experiencing an emotional event. Severe flushes are accompanied by a fall in blood pressure and a rise in pulse rate. Many people experience excessive tearing. As the disease progresses, these episodes may last longer and become more diffuse. […] Often the most debilitating component of the syndrome, diarrhea occurs in 80% of NETs patients who experience symptoms of carcinoid syndrome. Instances may vary from a few to more than 30 per day, with typically watery and non-bloody stool. This can be accompanied by abdominal cramping and presents a risk of dehydration.

• #9 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/about-carcinoid-syndrome

  Some neuroendocrine tumours (NETs) make large amounts of hormones and proteins. The most common substance they make is serotonin. They sometimes release serotonin and the other proteins into the bloodstream. This can cause a collection of symptoms called carcinoid syndrome. […] Carcinoid syndrome is most common in people with a small bowel NET which has spread to the liver. It can also happen in people with lung and pancreatic NETs. But this is less common. […] The main symptoms of carcinoid syndrome are: […] Flushing of the skin. The skin of your face, neck and chest might look red (flushed). It may also feel warm and itchy. 85 out of every 100 people (85%) with carcinoid syndrome have this symptom. Flushing of the skin is often unexpected and unpredictable. Some people find there are triggers. For example, certain foods, drinking coffee or alcohol, stress or exercise.

• #10 Carcinoid Syndrome Symptoms — The Healing NET Foundation

  https://www.thehealingnet.org/net-medical-care/2021/6/29/managing-carcinoid-syndrome-the-5-es

  EATING Large meals, spicy foods, and foods high in nitrogen-containing compounds called amines can trigger symptoms of carcinoid syndrome. Tomato-based foods, caffeine, chocolate, nuts and raw vegetables are common triggers. […] EXERCISE This trigger is highly variable from person to person, but in general physical stress may activate symptoms. The trick here is not to overdo. If you are not used to a particular exercise regimen, take it slowly and work up your tolerance. […] EMOTIONS Strong emotions such as anger, stress and anxiety can trigger symptoms. While it is impossible to completely avoid stress in everyday life, patients with carcinoid syndrome should work to reduce stress levels. […] EPINEPHRINE Certain medical or dental procedures may require numbing agents or anesthetics, which could contain epinephrine. In small doses it is usually quite safe, but epinephrine could trigger symptoms. Inform providers of your carcinoid syndrome diagnosis so they are aware and can consider alternatives.

• #11 Carcinoid syndrome: Causes and Management – DermNet

  https://dermnetnz.org/topics/carcinoid-syndrome

  Carcinoid syndrome is characterised by episodic cutaneous flushing, diarrhoea, and wheezing. […] Carcinoid symptoms are more common in those with bowel tumours, particularly when they have spread to the liver. […] The main cutaneous feature of carcinoid syndrome is flushing, which occurs in 75% of cases. This is caused by transient dilation of blood vessels. […] Flushing could be spontaneous or triggered by psychological stress, physical stress, infection, alcohol, food items which are either spicy or rich in amines, and medications. […] Carcinoid syndrome may also cause other symptoms such as weight loss, low blood pressure, and abdominal pain. […] Carcinoid syndrome can cause carcinoid crisis, which involves cutaneous flushing, hypotension, tachycardia/arrhythmias, bronchospasm, and/or sometimes hyperthermia.

• #12 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Flushing is the clinical hallmark of carcinoid syndrome and occurs in 85% of NETs patients who experience symptoms of carcinoid syndrome. Flushing is a sudden, intense reddening of the skin with a warming and/or burning sensation of the face, head, and upper chest. These episodes occur spontaneously and can last anywhere from 30 seconds to 30 minutes, but they can also be provoked by eating, drinking alcohol, coffee, spices, or experiencing an emotional event. Severe flushes are accompanied by a fall in blood pressure and a rise in pulse rate. Many people experience excessive tearing. As the disease progresses, these episodes may last longer and become more diffuse. […] Often the most debilitating component of the syndrome, diarrhea occurs in 80% of NETs patients who experience symptoms of carcinoid syndrome. Instances may vary from a few to more than 30 per day, with typically watery and non-bloody stool. This can be accompanied by abdominal cramping and presents a risk of dehydration.

• #13 Malignant Carcinoid Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/282515-clinical

  Flushing is a phenomenon in which transient vasodilation causes reddening of the face, head, neck, and the upper chest and epigastric areas. Flushing is the most frequently reported symptom and may be brief (eg, 2-5 min) or may last for several hours, usually in later disease stages. […] Flushing may be accompanied by tachycardia, while the blood pressure usually falls or does not change. Malignant carcinoid syndrome is not a cause of sustained hypertension, and a rise in blood pressure during flushing is rare. […] Right heart problems may develop because the tricuspid valve is stenosed by serotonin action, causing shortness of breath after a few years. However, carcinoid heart disease may produce no symptoms or clinical signs; for that reason, some authors have advocated screening with echocardiography in all patients with carcinoid syndrome.

• #14 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Common clinical features include flushing, wheezing, gastrointestinal disturbances (eg, diarrhea and malabsorption), niacin deficiency leading to pellagra, cardiac complications including right-sided valvular disease, most often tricuspid regurgitation, fatigue, and in some cases, cognitive impairment. […] Flushing is the most prevalent symptom, reported in approximately 85% of patients. […] Diarrhea, affecting about 80% of patients, is another hallmark symptom. It tends to be chronic, explosive, nonbloody, and watery, with patients reporting up to 30 bowel movements per day. […] Cardiac involvement occurs in 60% to 70% of patients and is caused by fibrotic plaque-like deposits on the endocardium, valves, and other cardiac structures, eg, the pulmonary and aortic arteries. […] Although less common, bronchospasm affects 10% to 20% of patients and typically manifests as wheezing and difficulty breathing, often during flushing episodes.

• #15 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Diarrhoea means you have changes to: the consistency of your poo (stool) – for example it is more watery than usual; how often you are going – for example over 24 hours you might have 2 or more loose bowel movements than usual; how much you are passing (the volume) when you have your bowels open. Diarrhoea can be severe. Some people with carcinoid syndrome have diarrhoea more than 30 times a day. 80 out of every 100 people (80%) with carcinoid syndrome have diarrhoea. […] Other symptoms of carcinoid syndrome include: tummy (abdominal) pain; red spidery marks on your skin caused by small broken blood vessels – this is called telangiectasia; a whistling sound when breathing – this is called wheezing; fast heartbeat and palpitations; a build up of fluid in your legs and ankles. […] Carcinoid crisis is a more serious version of carcinoid syndrome. It happens when NETs make large amounts of hormones and proteins. A carcinoid crisis can happen for no reason. In some people, an anaesthetic or treatment such as surgery or chemotherapy can set it off. Symptoms of carcinoid crisis are severe and might include: sudden, severe changes to your blood pressure – this might cause you to feel dizzy and pass out; palpitations; difficulties with breathing and a whistling sound when breathing – this is called wheezing; sudden severe redness of the skin – this is called flushing; very severe (profuse) diarrhoea.

• #16 Malignant Carcinoid Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/282515-clinical

  Other common problems include the following: Asthma, Wheezing, Dyspnea, Palpitations, Low blood pressure, Fatigue, Dizziness, Asthenia. […] Debilitating diarrhea is common and may have a secretory component. As many as 20 episodes of diarrhea per day are possible and cause marked debilitation due to fluid, electrolyte, and protein depletion. The diarrhea persists with fasting and fails to disappear when the patient is fed intravenously. The diarrhea is usually accompanied by flushing, but occurs alone in approximately 15% of patients. […] Carcinoid heart disease is reported in approximately 50-60% of all patients with malignant carcinoid syndrome and is severe in approximately 25%. Carcinoid heart disease occurs primarily on the right side of the heart but may involve the left side to a minimal degree.

• #17 Gastrointestinal Neuroendocrine Tumors and Carcinoid Syndrome – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors-nets/gastrointestinal-neuroendocrine-tumors-and-carcinoid-syndrome

  Carcinoid syndrome is a complex of symptoms and signs that develops in some people with endocrinologically active neuroendocrine tumors and is characterized by cutaneous flushing, abdominal cramps, and diarrhea. […] The most common (and often earliest) sign of carcinoid syndrome is uncomfortable flushing, typically of the head and neck. Flushing is often precipitated by emotional stress or the ingestion of food, hot beverages, or alcohol. […] Abdominal cramps with recurrent diarrhea occur and are often the patients major complaint. Malabsorption syndrome may occur. […] Some patients develop right-sided endocardial fibrosis, leading to pulmonic stenosis and tricuspid regurgitation. […] The main substances causing symptoms are serotonin, which causes abdominal cramps and diarrhea, and histamine, which causes flushing.

• #18 Carcinoid Tumor: Treatment, Symptoms, Meaning

  https://www.medicinenet.com/carcinoid_syndrome/article.htm

  Carcinoid syndrome is a combination of symptoms caused by the hormones and other chemical substances released by the tumors into the bloodstream. The symptoms of carcinoid syndrome vary depending on which hormones are released by the tumors. The common hormones released are serotonin, bradykinin, histamine, and chromogranin A. […] 6 typical carcinoid symptoms include: flushing, diarrhea, abdominal pain, wheezing due to bronchospasm, valvular heart disease, and surgery can provoke a complication known as a carcinoid crisis. […] Flushing is the most common symptom of carcinoid syndrome. An estimated 90% of the patients have flushing sometime during their illness. […] Diarrhea is the second most common symptom of carcinoid syndrome. An estimated 75% of patients with carcinoid syndrome have diarrhea.

• #19 Carcinoid Syndrome due to Neuroendocrine Tumors – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors/carcinoid-syndrome-due-to-neuroendocrine-tumors

  People with carcinoid syndrome usually have flushing and sometimes diarrhea. […] The most common, and often earliest symptom of carcinoid syndrome is uncomfortable flushing, typically of the head and neck. […] Excessive contraction of the intestine may result in abdominal cramping and diarrhea. The intestine may not be able to absorb nutrients properly, resulting in undernutrition and fatty, foul-smelling stools. […] Heart damage may occur, which can result in symptoms of right heart failure such as swelling of the feet and legs (edema). […] Wheezing and shortness of breath may result from blockage of airflow in the lungs. […] Some people with carcinoid syndrome lose interest in sex, and some men have erectile dysfunction. […] Fewer than 10% of people with neuroendocrine tumors develop symptoms of carcinoid syndrome, although this percentage varies depending on where the tumor is located. […] Neuroendocrine tumors grow so slowly that even people whose tumors have spread often survive for 10 to 15 years.

• #20 Carcinoid Syndrome: Symptoms, Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22103-carcinoid-syndrome

  Carcinoid syndrome symptoms include diarrhea, flushing and wheezing. […] Carcinoid syndrome symptoms caused by NET of GI. […] The three main carcinoid syndrome symptoms are flushing, wheezing and diarrhea. […] Studies suggest the most common symptoms include uncomfortable flushing of your head and neck, wheezing and shortness of breath (dyspnea), abdominal cramping and explosive, frequent diarrhea, fatty poops that smell bad, edema or swelling of your feet and legs, some people might lose interest in sex or have erectile dysfunction, jaundice, dizziness or feeling faint, and feeling like your heart is racing. […] Carcinoid syndrome symptoms get worse over time if untreated and can become a life-threatening condition called carcinoid crisis.

• #21 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Common clinical features include flushing, wheezing, gastrointestinal disturbances (eg, diarrhea and malabsorption), niacin deficiency leading to pellagra, cardiac complications including right-sided valvular disease, most often tricuspid regurgitation, fatigue, and in some cases, cognitive impairment. […] Flushing is the most prevalent symptom, reported in approximately 85% of patients. […] Diarrhea, affecting about 80% of patients, is another hallmark symptom. It tends to be chronic, explosive, nonbloody, and watery, with patients reporting up to 30 bowel movements per day. […] Cardiac involvement occurs in 60% to 70% of patients and is caused by fibrotic plaque-like deposits on the endocardium, valves, and other cardiac structures, eg, the pulmonary and aortic arteries. […] Although less common, bronchospasm affects 10% to 20% of patients and typically manifests as wheezing and difficulty breathing, often during flushing episodes.

• #22 Carcinoid syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/carcinoid-syndrome/symptoms-causes/syc-20370666

  Diarrhea. Frequent, watery stools sometimes accompanied by abdominal cramps may occur in people who have carcinoid syndrome. […] Difficulty breathing. Asthma-like signs and symptoms, such as wheezing and shortness of breath, may occur at the same time you experience skin flushing. […] Rapid heartbeat. Periods of a fast heart rate could be a sign of carcinoid syndrome.

• #23 Carcinoid syndrome and carcinoid tumours | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/carcinoid-syndrome-and-carcinoid-tumours/

  Carcinoid syndrome is the collection of symptoms some people get when a carcinoid tumour usually one that has spread to the liver releases hormones such as serotonin into the bloodstream. […] Typical symptoms of carcinoid syndrome include: diarrhoea, tummy pain and loss of appetite, flushing of the skin, particularly the face, fast heart rate, breathlessness and wheezing. […] Some people may also develop carcinoid heart disease, where the heart valves thicken and stop working properly. There is also a risk of developing a rare but serious reaction called a carcinoid crisis, which involves severe flushing, breathlessness and a drop in blood pressure. […] Symptoms of carcinoid syndrome can be treated with injections of octreotide and lanreotide. You may also be given medication to widen your airways (to relieve wheezing and breathlessness) and anti-diarrhoea medication. […] But as the tumour grows or spreads, it will produce more and more hormones, and it may eventually be difficult to completely control symptoms with medication.

• #24 Malignant Carcinoid Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/282515-clinical

  Other common problems include the following: Asthma, Wheezing, Dyspnea, Palpitations, Low blood pressure, Fatigue, Dizziness, Asthenia. […] Debilitating diarrhea is common and may have a secretory component. As many as 20 episodes of diarrhea per day are possible and cause marked debilitation due to fluid, electrolyte, and protein depletion. The diarrhea persists with fasting and fails to disappear when the patient is fed intravenously. The diarrhea is usually accompanied by flushing, but occurs alone in approximately 15% of patients. […] Carcinoid heart disease is reported in approximately 50-60% of all patients with malignant carcinoid syndrome and is severe in approximately 25%. Carcinoid heart disease occurs primarily on the right side of the heart but may involve the left side to a minimal degree.

• #25 Carcinoid Tumor: Treatment, Symptoms, Meaning

  https://www.medicinenet.com/carcinoid_syndrome/article.htm

  Heart disease occurs in an estimated 50% of patients with carcinoid syndrome. Carcinoid syndrome typically causes scarring and stiffness of the tricuspid and pulmonic valves of the right side of the heart. […] Carcinoid crisis is a dangerous condition that can occur at the time of surgery. It is characterized by a sudden and profound drop in blood pressure causing shock, sometimes accompanied by an abnormally fast heart rate, high blood glucose, and severe bronchospasm. […] Wheezing occurs in approximately 10% of patients with carcinoid syndrome. It is the result of bronchospasm caused by hormones released by carcinoid tumors. […] Abdominal pain is common in patients with carcinoid syndrome. The pain may be due to tumor metastases in the liver, tumor invading neighboring tissues and organs, or tumor-causing bowel obstruction.

• #26 Malignant Carcinoid Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/282515-clinical

  Flushing is a phenomenon in which transient vasodilation causes reddening of the face, head, neck, and the upper chest and epigastric areas. Flushing is the most frequently reported symptom and may be brief (eg, 2-5 min) or may last for several hours, usually in later disease stages. […] Flushing may be accompanied by tachycardia, while the blood pressure usually falls or does not change. Malignant carcinoid syndrome is not a cause of sustained hypertension, and a rise in blood pressure during flushing is rare. […] Right heart problems may develop because the tricuspid valve is stenosed by serotonin action, causing shortness of breath after a few years. However, carcinoid heart disease may produce no symptoms or clinical signs; for that reason, some authors have advocated screening with echocardiography in all patients with carcinoid syndrome.

• #27 Carcinoid syndrome – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/carcinoid-syndrome/symptoms-causes/syc-20370666

  Diarrhea. Frequent, watery stools sometimes accompanied by abdominal cramps may occur in people who have carcinoid syndrome. […] Difficulty breathing. Asthma-like signs and symptoms, such as wheezing and shortness of breath, may occur at the same time you experience skin flushing. […] Rapid heartbeat. Periods of a fast heart rate could be a sign of carcinoid syndrome.

• #28 Carcinoid Syndrome – NETRF

  https://netrf.org/old-for-patients/living-with-nets/carcinoid-syndrome/

  Carcinoid syndrome is a constellation, collection, or group of symptoms experienced by a subset of people who have a neuroendocrine tumor. […] The signs and symptoms of carcinoid syndrome can be broad but the most common ones include: Flushing, Diarrhea. […] Less common signs and symptoms of carcinoid syndrome include: Wheezing, Abdominal pain, Visible thread-like blood vessels (also called telangiectasias), Low blood pressure causing dizziness or feeling you may pass out (also called hypotension). […] Pain in the abdomen that can be progressive. […] Low blood pressure (or hypotension) occurs when blood pressure is lower than 90/60 mm Hg. […] Collections of tiny blood vessels that appear close to the surface of the skin on the faces of people with NETs, which are a consequence of repeated severe flushing episodes.

• #29 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Common clinical features include flushing, wheezing, gastrointestinal disturbances (eg, diarrhea and malabsorption), niacin deficiency leading to pellagra, cardiac complications including right-sided valvular disease, most often tricuspid regurgitation, fatigue, and in some cases, cognitive impairment. […] Flushing is the most prevalent symptom, reported in approximately 85% of patients. […] Diarrhea, affecting about 80% of patients, is another hallmark symptom. It tends to be chronic, explosive, nonbloody, and watery, with patients reporting up to 30 bowel movements per day. […] Cardiac involvement occurs in 60% to 70% of patients and is caused by fibrotic plaque-like deposits on the endocardium, valves, and other cardiac structures, eg, the pulmonary and aortic arteries. […] Although less common, bronchospasm affects 10% to 20% of patients and typically manifests as wheezing and difficulty breathing, often during flushing episodes.

• #30 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Carcinoid heart disease happens when there is a build up of plaque or scar tissue in the heart valves and the heart muscle. Over time, the valves become thicker and this can affect how the heart works. Carcinoid heart disease happens in up to 50 out of every 100 people with carcinoid syndrome (up to 50%). Symptoms of carcinoid heart disease are usually vague. Most people don’t have any symptoms until it is severe. Symptoms include: feeling breathless; tiredness (fatigue); a build up of fluid in your body causing swelling; weight loss. […] It can be difficult to cope with carcinoid syndrome and its complications. You might have ongoing symptoms such as diarrhoea and flushing of the skin that are difficult to control.

• #31 Malignant Carcinoid Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/282515-clinical

  Flushing is a phenomenon in which transient vasodilation causes reddening of the face, head, neck, and the upper chest and epigastric areas. Flushing is the most frequently reported symptom and may be brief (eg, 2-5 min) or may last for several hours, usually in later disease stages. […] Flushing may be accompanied by tachycardia, while the blood pressure usually falls or does not change. Malignant carcinoid syndrome is not a cause of sustained hypertension, and a rise in blood pressure during flushing is rare. […] Right heart problems may develop because the tricuspid valve is stenosed by serotonin action, causing shortness of breath after a few years. However, carcinoid heart disease may produce no symptoms or clinical signs; for that reason, some authors have advocated screening with echocardiography in all patients with carcinoid syndrome.

• #32 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Diarrhoea means you have changes to: the consistency of your poo (stool) – for example it is more watery than usual; how often you are going – for example over 24 hours you might have 2 or more loose bowel movements than usual; how much you are passing (the volume) when you have your bowels open. Diarrhoea can be severe. Some people with carcinoid syndrome have diarrhoea more than 30 times a day. 80 out of every 100 people (80%) with carcinoid syndrome have diarrhoea. […] Other symptoms of carcinoid syndrome include: tummy (abdominal) pain; red spidery marks on your skin caused by small broken blood vessels – this is called telangiectasia; a whistling sound when breathing – this is called wheezing; fast heartbeat and palpitations; a build up of fluid in your legs and ankles. […] Carcinoid crisis is a more serious version of carcinoid syndrome. It happens when NETs make large amounts of hormones and proteins. A carcinoid crisis can happen for no reason. In some people, an anaesthetic or treatment such as surgery or chemotherapy can set it off. Symptoms of carcinoid crisis are severe and might include: sudden, severe changes to your blood pressure – this might cause you to feel dizzy and pass out; palpitations; difficulties with breathing and a whistling sound when breathing – this is called wheezing; sudden severe redness of the skin – this is called flushing; very severe (profuse) diarrhoea.

• #33 Carcinoid Syndrome – NETRF

  https://netrf.org/old-for-patients/living-with-nets/carcinoid-syndrome/

  Carcinoid syndrome is a constellation, collection, or group of symptoms experienced by a subset of people who have a neuroendocrine tumor. […] The signs and symptoms of carcinoid syndrome can be broad but the most common ones include: Flushing, Diarrhea. […] Less common signs and symptoms of carcinoid syndrome include: Wheezing, Abdominal pain, Visible thread-like blood vessels (also called telangiectasias), Low blood pressure causing dizziness or feeling you may pass out (also called hypotension). […] Pain in the abdomen that can be progressive. […] Low blood pressure (or hypotension) occurs when blood pressure is lower than 90/60 mm Hg. […] Collections of tiny blood vessels that appear close to the surface of the skin on the faces of people with NETs, which are a consequence of repeated severe flushing episodes.

• #34 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Additional, less common manifestations of carcinoid syndrome include pellagra, which is caused by niacin deficiency due to excessive tryptophan being used for serotonin synthesis. […] The prognosis of carcinoid syndrome is dependent on the underlying tumor characteristics, stage, and extent of metastasis, as well as the presence of associated complications, eg, carcinoid heart disease or carcinoid crisis. […] One of the most significant complications is carcinoid heart disease, characterized by fibrotic plaque deposition on the endocardium of right-sided heart valves, leading to tricuspid regurgitation, pulmonic stenosis, and eventually right-sided heart failure.

• #35 Carcinoid syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Carcinoid_syndrome

  Diarrhea: The second most common finding occurring in about 80% of people. It may also be associated with abdominal cramping and pain. […] Bronchoconstriction: A relatively rare symptom affects about 15% of those having carcinoid syndrome and often accompanies flushing, sneezing, and shortness of breath. […] Heart Disease: About 60-70% of those affected by carcinoid syndrome develop cardiac complications. This mainly affects the right side of the heart causing fibrosis of the tricuspid and pulmonic valves. This may be heard as a murmur and may contribute to fatigue. […] Less common symptoms include malabsorption (leading to pellagra), fatigue, muscle loss, and cognitive impairment. Late complications may include mesenteric and retroperitoneal fibroses as well. […] Disease progression is difficult to ascertain because the disease can metastasize anywhere in the body and can be too small to identify with any current technology. Markers of the condition such as chromogranin-A are imperfect indicators of disease progression.

• #36 Carcinoid Tumor: Treatment, Symptoms, Meaning

  https://www.medicinenet.com/carcinoid_syndrome/article.htm

  Heart disease occurs in an estimated 50% of patients with carcinoid syndrome. Carcinoid syndrome typically causes scarring and stiffness of the tricuspid and pulmonic valves of the right side of the heart. […] Carcinoid crisis is a dangerous condition that can occur at the time of surgery. It is characterized by a sudden and profound drop in blood pressure causing shock, sometimes accompanied by an abnormally fast heart rate, high blood glucose, and severe bronchospasm. […] Wheezing occurs in approximately 10% of patients with carcinoid syndrome. It is the result of bronchospasm caused by hormones released by carcinoid tumors. […] Abdominal pain is common in patients with carcinoid syndrome. The pain may be due to tumor metastases in the liver, tumor invading neighboring tissues and organs, or tumor-causing bowel obstruction.

• #37 Carcinoid Syndrome – UF Health

  https://ufhealth.org/conditions-and-treatments/carcinoid-syndrome

  Carcinoid syndrome is a group of symptoms associated with carcinoid tumors. These tumors release too much of the hormone serotonin, as well as several other chemicals. The hormones cause the blood vessels to open (dilate). This causes carcinoid syndrome. […] The carcinoid syndrome is made up of four main symptoms including: Flushing (face, neck, or upper chest), or widened blood vessels seen on the skin (telangiectasias) […] Difficulty breathing, such as wheezing […] Diarrhea […] Heart problems, such as leaking heart valves, slow heartbeat, low or high blood pressure. […] Symptoms are sometimes brought on by physical exertion, or eating or drinking things such as blue cheese, chocolate, or red wine. […] The outlook in people with carcinoid syndrome is sometimes different from the outlook in people who have carcinoid tumors without the syndrome. Prognosis also depends on the site of tumor. In people with the syndrome, the tumor has usually spread to the liver. This lowers the survival rate. People with carcinoid syndrome are also more likely to have a separate cancer (second primary tumor) at the same time. Overall, the prognosis is usually excellent.

• #38 Signs and Symptoms of Gastrointestinal Carcinoid Tumors | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/detection-diagnosis-staging/signs-symptoms.html

  Most gastrointestinal (GI) carcinoids grow slowly. If they do cause symptoms, they tend to be vague. […] A tumor usually has to grow fairly large before it completely blocks (obstructs) the intestine and causes severe belly pain, nausea and vomiting, and a potentially life-threatening situation. […] About 1 out of 10 carcinoid tumors release enough hormone-like substances into the bloodstream to cause carcinoid syndrome symptoms. These include: Facial flushing (redness and warm feeling), Severe diarrhea, Wheezing, Fast heartbeat. […] Many people find that factors such as stress, heavy exercise, and drinking alcohol trigger these symptoms. Over a long time, these hormone-like substances can damage heart valves, causing shortness of breath, weakness, and a heart murmur (an abnormal heart sound). […] Most cases of carcinoid syndrome occur only after the cancer has already spread to other parts of the body. Carcinoid tumors in the midgut (appendix, small intestine, cecum and ascending colon) that spread to the liver are most likely to cause carcinoid syndrome.

• #39 What is your neuroendocrine tumor story? Let’s share! | Neuroendocrine tumor Forum

  https://www.carenity.us/forum/neuroendocrine-tumor/living-with-neuroendocrine-tumour/what-is-your-neuroendocrine-tumour-story-lets-share-2245

  I was repeatedly having diarrhea, vomiting and pains in my stomach and I was losing a lot of weight, so I went in and after all the tests they found my tumors. […] I had been having really horrible stomach pain and diarrhea and I was losing weight like crazy. […] I was having issues with diarrhea for awhile, I thought it was stress induced, on a routine colonoscopy they found an NET. in the distal ileum. […] I started having bouts of significant gut pain and docs weren’t sure why. […] I kept turning bright red in my face and chest which would last for several hours and then subside. […] I still suffer stomach pain, cramps, gas, diarrhea with episodes of incontinence two years later. It has definitely impacted my quality of life. […] There is a syndrome that this kind of tumor can cause involving hormones being released, but they said it is very very rare.

• #40 FF #137Carcinoid Syndrome: Symptom Management | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/carcinoid-syndrome-symptom-management/

  Carcinoid syndrome (CS) is a symptom complex resulting from hormone secretion in patients with carcinoid tumors. CS becomes manifested only when sufficient concentration of hormones reaches the systemic circulation, most commonly in the presence of liver metastases. […] The CS includes the complex of: flushing, diarrhea, abdominal cramping, cyanosis, bronchoconstriction, and symptoms of right heart failure. Compared with the general population and other cancer patients, CS sufferers may also be at increased risk for cognitive impairment. […] Serotonin-secreting tumors cause diarrhea and abdominal cramping; bradykinin and histamine secretion lead to flushing and cyanosis.

• #41 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Additional, less common manifestations of carcinoid syndrome include pellagra, which is caused by niacin deficiency due to excessive tryptophan being used for serotonin synthesis. […] The prognosis of carcinoid syndrome is dependent on the underlying tumor characteristics, stage, and extent of metastasis, as well as the presence of associated complications, eg, carcinoid heart disease or carcinoid crisis. […] One of the most significant complications is carcinoid heart disease, characterized by fibrotic plaque deposition on the endocardium of right-sided heart valves, leading to tricuspid regurgitation, pulmonic stenosis, and eventually right-sided heart failure.

• #42 Carcinoid Cancer: Definition, Symptoms, Prognosis, and More

  https://www.verywellhealth.com/what-is-carcinoid-cancer-5092725

  Carcinoid tumors can be asymptomatic, with fewer than 10% of people who have them showing symptoms (depending on the location of the tumor). […] People with carcinoid cancer may or may not experience symptoms. If symptoms are present, they depend on where in the body the tumor(s) is located and can vary. […] Carcinoid syndrome develops from tumors that produce hormones. It occurs in about 10% of people with a carcinoid tumor. […] Symptoms of carcinoid syndrome include: Facial flushing (warmth and redness of the face, head, and upper chest), Nausea/vomiting, Diarrhea, Heart palpitations, Fainting, Wheezing, Change in blood pressure (usually a decrease or low blood pressure), Change in weight (gain or loss), Malnutrition, Dehydration, Weakness, Aching in muscles and joints, Peptic ulcer.

• #43 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Wheezing and dyspnea occur in 10-20% of patients, often during flushing episodes. […] These are plaque-like deposits of fibrous tissue, most commonly found on valvular cusps or in cardiac chambers. […] Muscle wasting, retroperitoneal fibrosis leading to ureteral obstruction, and persistent facial edema. […] In the early stages of carcinoid syndrome, the symptoms are relatively nonspecific. The differential diagnoses for diarrhea, vague abdominal symptoms, and even flushing are rather broad. Patients are often given an initial diagnosis of irritable bowel syndrome, and only later does the true diagnosis become apparent. […] The median time from onset of symptoms attributable to the tumor and diagnosis is 9.2 years. […] Many of the major symptoms of carcinoid syndrome tend to be on the dramatic side. Spontaneous-onset of flushing episodes, during which some patients report “feeling on fire.” Frequent diarrhea that can hit anytime, anywhere. Difficulty breathing, which as any asthma sufferer can attest, induces a panicked feeling.

• #44 Carcinoid Syndrome due to Neuroendocrine Tumors – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors/carcinoid-syndrome-due-to-neuroendocrine-tumors

  People with carcinoid syndrome usually have flushing and sometimes diarrhea. […] The most common, and often earliest symptom of carcinoid syndrome is uncomfortable flushing, typically of the head and neck. […] Excessive contraction of the intestine may result in abdominal cramping and diarrhea. The intestine may not be able to absorb nutrients properly, resulting in undernutrition and fatty, foul-smelling stools. […] Heart damage may occur, which can result in symptoms of right heart failure such as swelling of the feet and legs (edema). […] Wheezing and shortness of breath may result from blockage of airflow in the lungs. […] Some people with carcinoid syndrome lose interest in sex, and some men have erectile dysfunction. […] Fewer than 10% of people with neuroendocrine tumors develop symptoms of carcinoid syndrome, although this percentage varies depending on where the tumor is located. […] Neuroendocrine tumors grow so slowly that even people whose tumors have spread often survive for 10 to 15 years.

• #45 Carcinoid Syndrome: Symptoms, Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22103-carcinoid-syndrome

  Carcinoid syndrome symptoms include diarrhea, flushing and wheezing. […] Carcinoid syndrome symptoms caused by NET of GI. […] The three main carcinoid syndrome symptoms are flushing, wheezing and diarrhea. […] Studies suggest the most common symptoms include uncomfortable flushing of your head and neck, wheezing and shortness of breath (dyspnea), abdominal cramping and explosive, frequent diarrhea, fatty poops that smell bad, edema or swelling of your feet and legs, some people might lose interest in sex or have erectile dysfunction, jaundice, dizziness or feeling faint, and feeling like your heart is racing. […] Carcinoid syndrome symptoms get worse over time if untreated and can become a life-threatening condition called carcinoid crisis.

• #46 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Flushing is the clinical hallmark of carcinoid syndrome and occurs in 85% of NETs patients who experience symptoms of carcinoid syndrome. Flushing is a sudden, intense reddening of the skin with a warming and/or burning sensation of the face, head, and upper chest. These episodes occur spontaneously and can last anywhere from 30 seconds to 30 minutes, but they can also be provoked by eating, drinking alcohol, coffee, spices, or experiencing an emotional event. Severe flushes are accompanied by a fall in blood pressure and a rise in pulse rate. Many people experience excessive tearing. As the disease progresses, these episodes may last longer and become more diffuse. […] Often the most debilitating component of the syndrome, diarrhea occurs in 80% of NETs patients who experience symptoms of carcinoid syndrome. Instances may vary from a few to more than 30 per day, with typically watery and non-bloody stool. This can be accompanied by abdominal cramping and presents a risk of dehydration.

• #47 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Common clinical features include flushing, wheezing, gastrointestinal disturbances (eg, diarrhea and malabsorption), niacin deficiency leading to pellagra, cardiac complications including right-sided valvular disease, most often tricuspid regurgitation, fatigue, and in some cases, cognitive impairment. […] Flushing is the most prevalent symptom, reported in approximately 85% of patients. […] Diarrhea, affecting about 80% of patients, is another hallmark symptom. It tends to be chronic, explosive, nonbloody, and watery, with patients reporting up to 30 bowel movements per day. […] Cardiac involvement occurs in 60% to 70% of patients and is caused by fibrotic plaque-like deposits on the endocardium, valves, and other cardiac structures, eg, the pulmonary and aortic arteries. […] Although less common, bronchospasm affects 10% to 20% of patients and typically manifests as wheezing and difficulty breathing, often during flushing episodes.

• #48 Carcinoid syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Carcinoid_syndrome

  Diarrhea: The second most common finding occurring in about 80% of people. It may also be associated with abdominal cramping and pain. […] Bronchoconstriction: A relatively rare symptom affects about 15% of those having carcinoid syndrome and often accompanies flushing, sneezing, and shortness of breath. […] Heart Disease: About 60-70% of those affected by carcinoid syndrome develop cardiac complications. This mainly affects the right side of the heart causing fibrosis of the tricuspid and pulmonic valves. This may be heard as a murmur and may contribute to fatigue. […] Less common symptoms include malabsorption (leading to pellagra), fatigue, muscle loss, and cognitive impairment. Late complications may include mesenteric and retroperitoneal fibroses as well. […] Disease progression is difficult to ascertain because the disease can metastasize anywhere in the body and can be too small to identify with any current technology. Markers of the condition such as chromogranin-A are imperfect indicators of disease progression.

• #49 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Carcinoid heart disease happens when there is a build up of plaque or scar tissue in the heart valves and the heart muscle. Over time, the valves become thicker and this can affect how the heart works. Carcinoid heart disease happens in up to 50 out of every 100 people with carcinoid syndrome (up to 50%). Symptoms of carcinoid heart disease are usually vague. Most people don’t have any symptoms until it is severe. Symptoms include: feeling breathless; tiredness (fatigue); a build up of fluid in your body causing swelling; weight loss. […] It can be difficult to cope with carcinoid syndrome and its complications. You might have ongoing symptoms such as diarrhoea and flushing of the skin that are difficult to control.

• #50 Signs and Symptoms of Gastrointestinal Carcinoid Tumors | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/detection-diagnosis-staging/signs-symptoms.html

  Most gastrointestinal (GI) carcinoids grow slowly. If they do cause symptoms, they tend to be vague. […] A tumor usually has to grow fairly large before it completely blocks (obstructs) the intestine and causes severe belly pain, nausea and vomiting, and a potentially life-threatening situation. […] About 1 out of 10 carcinoid tumors release enough hormone-like substances into the bloodstream to cause carcinoid syndrome symptoms. These include: Facial flushing (redness and warm feeling), Severe diarrhea, Wheezing, Fast heartbeat. […] Many people find that factors such as stress, heavy exercise, and drinking alcohol trigger these symptoms. Over a long time, these hormone-like substances can damage heart valves, causing shortness of breath, weakness, and a heart murmur (an abnormal heart sound). […] Most cases of carcinoid syndrome occur only after the cancer has already spread to other parts of the body. Carcinoid tumors in the midgut (appendix, small intestine, cecum and ascending colon) that spread to the liver are most likely to cause carcinoid syndrome.

• #51 Malignant Carcinoid Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/282515-clinical

  Flushing is a phenomenon in which transient vasodilation causes reddening of the face, head, neck, and the upper chest and epigastric areas. Flushing is the most frequently reported symptom and may be brief (eg, 2-5 min) or may last for several hours, usually in later disease stages. […] Flushing may be accompanied by tachycardia, while the blood pressure usually falls or does not change. Malignant carcinoid syndrome is not a cause of sustained hypertension, and a rise in blood pressure during flushing is rare. […] Right heart problems may develop because the tricuspid valve is stenosed by serotonin action, causing shortness of breath after a few years. However, carcinoid heart disease may produce no symptoms or clinical signs; for that reason, some authors have advocated screening with echocardiography in all patients with carcinoid syndrome.

• #52 Gastrointestinal Neuroendocrine Tumors and Carcinoid Syndrome – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors-nets/gastrointestinal-neuroendocrine-tumors-and-carcinoid-syndrome

  Carcinoid syndrome is a complex of symptoms and signs that develops in some people with endocrinologically active neuroendocrine tumors and is characterized by cutaneous flushing, abdominal cramps, and diarrhea. […] The most common (and often earliest) sign of carcinoid syndrome is uncomfortable flushing, typically of the head and neck. Flushing is often precipitated by emotional stress or the ingestion of food, hot beverages, or alcohol. […] Abdominal cramps with recurrent diarrhea occur and are often the patients major complaint. Malabsorption syndrome may occur. […] Some patients develop right-sided endocardial fibrosis, leading to pulmonic stenosis and tricuspid regurgitation. […] The main substances causing symptoms are serotonin, which causes abdominal cramps and diarrhea, and histamine, which causes flushing.

• #53 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Carcinoid heart disease happens when there is a build up of plaque or scar tissue in the heart valves and the heart muscle. Over time, the valves become thicker and this can affect how the heart works. Carcinoid heart disease happens in up to 50 out of every 100 people with carcinoid syndrome (up to 50%). Symptoms of carcinoid heart disease are usually vague. Most people don’t have any symptoms until it is severe. Symptoms include: feeling breathless; tiredness (fatigue); a build up of fluid in your body causing swelling; weight loss. […] It can be difficult to cope with carcinoid syndrome and its complications. You might have ongoing symptoms such as diarrhoea and flushing of the skin that are difficult to control.

• #54 Carcinoid syndrome | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/carcinoid-syndrome

  Some neuroendocrine tumours (NETs) produce too much of a hormone-like substance called serotonin. This is more common in NETs of the small bowel that have spread to the liver. It can cause a collection of symptoms called carcinoid syndrome. […] Symptoms of carcinoid syndrome can include: diarrhoea, the skin on your face and upper chest turning pink or purple (flushing), wheezing which is similar to asthma, tiredness (fatigue). […] Sometimes, the symptoms of carcinoid syndrome can be particularly bad. You may have severe diarrhoea, flushing, abdominal pain and palpitations. This is called carcinoid crisis. […] Sometimes, both serotonin and another substance the NET produces (called tachykinin) can affect the heart. This can cause carcinoid heart disease. The main symptoms are: breathlessness, swollen ankles.

• #55 Carcinoid syndrome: update on the pathophysiology and treatment | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-carcinoid-syndrome-update-on-pathophysiology-S1807593222011310

  While these agents provide significant relief from CS symptoms, there is inevitable clinical progression, when new therapeutic interventions are needed. […] Symptoms of right heart failure, such as peripheral edema, abdominal discomfort and indigestion, early satiety and cachexia, appear during the course of its evolution. As the condition worsens, fatigue, dyspnea upon exertion, jugular swelling, and ascites are observed. If these symptoms are not treated, progression of the manifestations leads to death from heart failure. […] Mesenteric fibrosis (MF) is another complication of uncontrolled CS. At least some signs of MF occur in approximately 50% of CS patients. […] The diagnosis of CS requires the combination of carcinoid symptoms and evidence of elevated levels of 5-HIAA in a 24-h urine sample. […] Unfortunately, all patients experience symptomatic progression of CS after a median of several months to years.

• #56 Carcinoid syndrome and carcinoid tumours | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/carcinoid-syndrome-and-carcinoid-tumours/

  Carcinoid syndrome is the collection of symptoms some people get when a carcinoid tumour usually one that has spread to the liver releases hormones such as serotonin into the bloodstream. […] Typical symptoms of carcinoid syndrome include: diarrhoea, tummy pain and loss of appetite, flushing of the skin, particularly the face, fast heart rate, breathlessness and wheezing. […] Some people may also develop carcinoid heart disease, where the heart valves thicken and stop working properly. There is also a risk of developing a rare but serious reaction called a carcinoid crisis, which involves severe flushing, breathlessness and a drop in blood pressure. […] Symptoms of carcinoid syndrome can be treated with injections of octreotide and lanreotide. You may also be given medication to widen your airways (to relieve wheezing and breathlessness) and anti-diarrhoea medication. […] But as the tumour grows or spreads, it will produce more and more hormones, and it may eventually be difficult to completely control symptoms with medication.

• #57 Carcinoid Syndrome: Causes, Symptoms, Treatments

  https://www.webmd.com/cancer/carcinoid-syndrome-and-carcinoid-tumors

  Carcinoid syndrome is a group of symptoms that result from a rare type of tumor called a carcinoid tumor. This tumor grows slowly, starting most often in cells that line the digestive tract or lung. […] Carcinoid syndrome occurs in fewer than 20% of those with a carcinoid tumor. The symptoms of carcinoid syndrome can affect many different parts of your body. You can take steps to improve these symptoms. […] In advanced cases, when the tumor has spread, the increased release of hormonal substances can cause a diverse set of symptoms. These may include: Facial flushing, redness, and a sudden rush of warmth in the face that is sometimes confused with the hot flashes of menopause, Diarrhea, A fast heartbeat, Wheezing, A sudden drop in blood pressure. […] Other symptoms — such as abdominal pain or intestinal bleeding — may also depend on the location of the carcinoid tumor. Symptoms may worsen over time as a result of complications, such as damage to heart valves, leading to shortness of breath and heart murmur. […] Seek immediate medical care if you have severe symptoms, because this may signal a life-threatening carcinoid crisis. Severe symptoms include: Severe, lasting flushing, Confusion, Very low blood pressure, A very rapid heartbeat, Trouble breathing, Bluish or purple skin color.

• #58 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/about-carcinoid-syndrome

  Diarrhoea means you have changes to: the consistency of your poo (stool) – for example it is more watery than usual; how often you are going – for example over 24 hours you might have 2 or more loose bowel movements than usual; how much you are passing (the volume) when you have your bowels open. Diarrhoea can be severe. Some people with carcinoid syndrome have diarrhoea more than 30 times a day. 80 out of every 100 people (80%) with carcinoid syndrome have diarrhoea. […] Other symptoms of carcinoid syndrome include: tummy (abdominal) pain; red spidery marks on your skin caused by small broken blood vessels – this is called telangiectasia; a whistling sound when breathing – this is called wheezing; fast heartbeat and palpitations; a build up of fluid in your legs and ankles. […] Carcinoid crisis is a more serious version of carcinoid syndrome. It happens when NETs make large amounts of hormones and proteins. A carcinoid crisis can happen for no reason. In some people, an anaesthetic or treatment such as surgery or chemotherapy can set it off. Symptoms of carcinoid crisis are severe and might include: sudden, severe changes to your blood pressure – this might cause you to feel dizzy and pass out; palpitations; difficulties with breathing and a whistling sound when breathing – this is called wheezing; sudden severe redness of the skin – this is called flushing; very severe (profuse) diarrhoea.

• #59 Carcinoid Tumor: Treatment, Symptoms, Meaning

  https://www.medicinenet.com/carcinoid_syndrome/article.htm

  Heart disease occurs in an estimated 50% of patients with carcinoid syndrome. Carcinoid syndrome typically causes scarring and stiffness of the tricuspid and pulmonic valves of the right side of the heart. […] Carcinoid crisis is a dangerous condition that can occur at the time of surgery. It is characterized by a sudden and profound drop in blood pressure causing shock, sometimes accompanied by an abnormally fast heart rate, high blood glucose, and severe bronchospasm. […] Wheezing occurs in approximately 10% of patients with carcinoid syndrome. It is the result of bronchospasm caused by hormones released by carcinoid tumors. […] Abdominal pain is common in patients with carcinoid syndrome. The pain may be due to tumor metastases in the liver, tumor invading neighboring tissues and organs, or tumor-causing bowel obstruction.

• #60 Carcinoid syndrome: Causes and Management – DermNet

  https://dermnetnz.org/topics/carcinoid-syndrome

  Carcinoid syndrome is characterised by episodic cutaneous flushing, diarrhoea, and wheezing. […] Carcinoid symptoms are more common in those with bowel tumours, particularly when they have spread to the liver. […] The main cutaneous feature of carcinoid syndrome is flushing, which occurs in 75% of cases. This is caused by transient dilation of blood vessels. […] Flushing could be spontaneous or triggered by psychological stress, physical stress, infection, alcohol, food items which are either spicy or rich in amines, and medications. […] Carcinoid syndrome may also cause other symptoms such as weight loss, low blood pressure, and abdominal pain. […] Carcinoid syndrome can cause carcinoid crisis, which involves cutaneous flushing, hypotension, tachycardia/arrhythmias, bronchospasm, and/or sometimes hyperthermia.

• #61 Carcinoid Crisis and Anaesthesia: Signs, Risks, Triggers & More

  https://neuroendocrine.org.au/treatments/carcinoid-crisis-and-anaesthesia/

  Sometimes, individuals with NETs experience a severe bout of something called carcinoid syndrome. Stress, certain medical procedures, or specific treatments can trigger it. This is referred to as a carcinoid crisis. […] The symptoms are intense, and can include: Sudden redness in the face, Stomach issues (upset stomach), Strong abdominal pain, Difficulty breathing, Rapid heartbeats, Changes in blood pressure, Diarrhoea, Wheezing. […] In extreme cases, it can lead to confusion or even a coma. […] A carcinoid crisis is marked by certain signs, like sudden low or high blood pressure causing instability, a fast heartbeat, flushing of the skin, asthma-like breathing issues (bronchospasm), or a rise in body temperature. […] Factors that make someone more prone to a carcinoid crisis include having a significant amount of tumour growth (especially in the liver), high levels of specific substances in the body, or issues with the heart due to the tumours.

• #62 Carcinoid Syndrome – OpenAnesthesia

  https://www.openanesthesia.org/keywords/carcinoid-syndrome/

  A life-threatening form of CS, known as carcinoid crisis, may be precipitated by physical manipulation of the tumor (including bedside palpation), chemical stimulation or tumor necrosis resulting from chemotherapy, and hepatic artery ligation or embolization. It may occur spontaneously or during the induction of anesthesia. […] Clinical manifestations of carcinoid crisis include severe flushing with associated dramatic changes in blood pressure, cardiac arrhythmias, bronchoconstriction, and mental status changes. […] The treatment of CHD includes the management of heart failure, treatment of the NE tumor, reduction in the production of related hormones (with the use of somatostatin analogs), and heart valve repair surgery. […] Telotristat ethyl, a tryptophan hydroxylase inhibitor, decreases the production of serotonin; thus, reducing the levels of 5-HIAA in 24-hour urine tests. It is a promising treatment to prevent or delay the onset of CHD. […] Symptoms of CS, such as bronchospasm, hypotension, and flushing can be treated successfully with octreotide as quickly as 15 seconds. Other drugs have been reported with variable success, including vasopressin and angiotensin.

• #63 Carcinoid Crisis and Anaesthesia: Signs, Risks, Triggers & More

  https://neuroendocrine.org.au/treatments/carcinoid-crisis-and-anaesthesia/

  Different things can set off a carcinoid crisis, like: Surgeries and specific treatments, Feeling anxious or stressed, Receiving anaesthesia, Feeling very cold during surgery, Taking certain drugs that can cause a reaction. […] Its hard to predict which patients might be at risk for a carcinoid crisis during surgery. […] To help prevent and manage a carcinoid crisis, a medicine called octreotide is used. It stops certain hormones from being released and slows down tumour growth. […] Patients who are at risk of carcinoid crisis should engage in open and proactive communication with their healthcare team to ensure their safety and well-being. If youve had a recent NET diagnosis, it is vital to inform your healthcare providers about your specific medical history, including any previous episodes of carcinoid crisis, triggers, and symptoms youve experienced. […] Establish a clear action plan with your healthcare team, which includes instructions on how to recognise the early signs of a carcinoid crisis and what immediate steps to take if one occurs.

• #64 Carcinoid Syndrome – UF Health

  https://ufhealth.org/conditions-and-treatments/carcinoid-syndrome

  A fatal form of carcinoid syndrome, carcinoid crisis, may occur as a side effect of surgery, anesthesia or chemotherapy. […] Carcinoid syndrome is the pattern of symptoms that typically are exhibited by people with carcinoid tumors. The symptoms include bright red facial flushing, diarrhea, and occasionally wheezing. A specific type of heart valve damage can occur, as well as other cardiac problems. Carcinoid tumors secrete excessive amounts of the hormone serotonin. Surgery with complete removal of the tumor tissue is the ideal treatment. It can result in a permanent cure if it is possible to remove the tumor entirely.

• #65 Carcinoid Tumor: Treatment, Symptoms, Meaning

  https://www.medicinenet.com/carcinoid_syndrome/article.htm

  Heart disease occurs in an estimated 50% of patients with carcinoid syndrome. Carcinoid syndrome typically causes scarring and stiffness of the tricuspid and pulmonic valves of the right side of the heart. […] Carcinoid crisis is a dangerous condition that can occur at the time of surgery. It is characterized by a sudden and profound drop in blood pressure causing shock, sometimes accompanied by an abnormally fast heart rate, high blood glucose, and severe bronchospasm. […] Wheezing occurs in approximately 10% of patients with carcinoid syndrome. It is the result of bronchospasm caused by hormones released by carcinoid tumors. […] Abdominal pain is common in patients with carcinoid syndrome. The pain may be due to tumor metastases in the liver, tumor invading neighboring tissues and organs, or tumor-causing bowel obstruction.

• #66 Carcinoid syndrome: update on the pathophysiology and treatment | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-carcinoid-syndrome-update-on-pathophysiology-S1807593222011310

  While these agents provide significant relief from CS symptoms, there is inevitable clinical progression, when new therapeutic interventions are needed. […] Symptoms of right heart failure, such as peripheral edema, abdominal discomfort and indigestion, early satiety and cachexia, appear during the course of its evolution. As the condition worsens, fatigue, dyspnea upon exertion, jugular swelling, and ascites are observed. If these symptoms are not treated, progression of the manifestations leads to death from heart failure. […] Mesenteric fibrosis (MF) is another complication of uncontrolled CS. At least some signs of MF occur in approximately 50% of CS patients. […] The diagnosis of CS requires the combination of carcinoid symptoms and evidence of elevated levels of 5-HIAA in a 24-h urine sample. […] Unfortunately, all patients experience symptomatic progression of CS after a median of several months to years.

• #67 What is Carcinoid Syndrome, and How Can Functional Medicine Help?

  https://www.rupahealth.com/post/what-is-carcinoid-syndrome-and-how-can-functional-medicine-help

  Some complications of carcinoid syndrome can be life-threatening, including carcinoid heart disease that can lead to heart failure and mesenteric fibrosis when inflammation and scarring of the mesentery occurs, causing scarring of the fold of tissue that attaches your intestines to the wall of your abdomen. In rare cases, a carcinoid crisis can occur due to surgery, other medical procedures, or traumatic events. This is an emergency that causes significant changes in blood pressure, including low blood pressure (hypotension), shortness of breath, confusion, and severe flushing.

• #68 Carcinoid syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Carcinoid_syndrome

  Diarrhea: The second most common finding occurring in about 80% of people. It may also be associated with abdominal cramping and pain. […] Bronchoconstriction: A relatively rare symptom affects about 15% of those having carcinoid syndrome and often accompanies flushing, sneezing, and shortness of breath. […] Heart Disease: About 60-70% of those affected by carcinoid syndrome develop cardiac complications. This mainly affects the right side of the heart causing fibrosis of the tricuspid and pulmonic valves. This may be heard as a murmur and may contribute to fatigue. […] Less common symptoms include malabsorption (leading to pellagra), fatigue, muscle loss, and cognitive impairment. Late complications may include mesenteric and retroperitoneal fibroses as well. […] Disease progression is difficult to ascertain because the disease can metastasize anywhere in the body and can be too small to identify with any current technology. Markers of the condition such as chromogranin-A are imperfect indicators of disease progression.

• #69 Carcinoid syndrome – GPnotebook

  https://gpnotebook.com/en-GB/pages/dermatology/carcinoid-syndrome

  The carcinoid syndrome develops when products, chiefly serotonin, are released by the tumour in large amounts and escape hepatic degradation. […] Hallmark symptoms of carcinoid syndrome are: flushing and diarrhea. […] Atypical signs and symptoms can include: wheezing, abdominal pain, valvular heart disease, telangiectasias, pellagra, complications of mesenteric fibrosis, including ureteral obstruction, bowel obstruction, and bowel ischemia. […] Symptoms are mediated by the release of serotonin (5-HT), histamine, kallikrein, prostaglandins, and tachykinins. […] The carcinoid syndrome is seen in two situations: intestinal carcinoids with hepatic metastases and extra-intestinal carcinoids. […] Diagnosis requires these symptoms and corresponding elevations in lab tests.

• #70 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Wheezing and dyspnea occur in 10-20% of patients, often during flushing episodes. […] These are plaque-like deposits of fibrous tissue, most commonly found on valvular cusps or in cardiac chambers. […] Muscle wasting, retroperitoneal fibrosis leading to ureteral obstruction, and persistent facial edema. […] In the early stages of carcinoid syndrome, the symptoms are relatively nonspecific. The differential diagnoses for diarrhea, vague abdominal symptoms, and even flushing are rather broad. Patients are often given an initial diagnosis of irritable bowel syndrome, and only later does the true diagnosis become apparent. […] The median time from onset of symptoms attributable to the tumor and diagnosis is 9.2 years. […] Many of the major symptoms of carcinoid syndrome tend to be on the dramatic side. Spontaneous-onset of flushing episodes, during which some patients report “feeling on fire.” Frequent diarrhea that can hit anytime, anywhere. Difficulty breathing, which as any asthma sufferer can attest, induces a panicked feeling.

• #71 Carcinoid Syndrome | UCSF Department of Surgery

  https://surgicaloncology.ucsf.edu/condition/carcinoid-syndrome

  Carcinoid syndrome is a disease defined by a constellation of symptoms, physical manifestations, and abnormal laboratory findings. […] Major symptoms include hot, red facial flushing, diarrhea and wheezing. […] Carcinoid syndrome occurs when the tumor produces excessive amounts of the hormone serotonin in an individual who has liver or ovarian metastases. […] In patients without spread to the liver, the serotonin hormones released by the intestinal tumor will be broken down to inactive substances, effectively destroyed. However, if the tumor has spread to the liver, ovaries, or retroperitoneum and liver enzymes can no longer destroy the excess hormones, they accumulate in the body and cause the debilitating symptoms of carcinoid syndrome. […] Symptoms of carcinoid syndrome are frequently mistaken for other diseases, such as Crohns disease, ulcerative colitis, or irritable bowel syndrome (IBS). […] About 10% of the people with a carcinoid tumor will develop carcinoid syndrome. […] Carcinoid crisis is a life-threatening form of carcinoid syndrome that results where there is an overwhelming release of biologically active compounds such as serotonin from the tumor.

• #72 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Wheezing and dyspnea occur in 10-20% of patients, often during flushing episodes. […] These are plaque-like deposits of fibrous tissue, most commonly found on valvular cusps or in cardiac chambers. […] Muscle wasting, retroperitoneal fibrosis leading to ureteral obstruction, and persistent facial edema. […] In the early stages of carcinoid syndrome, the symptoms are relatively nonspecific. The differential diagnoses for diarrhea, vague abdominal symptoms, and even flushing are rather broad. Patients are often given an initial diagnosis of irritable bowel syndrome, and only later does the true diagnosis become apparent. […] The median time from onset of symptoms attributable to the tumor and diagnosis is 9.2 years. […] Many of the major symptoms of carcinoid syndrome tend to be on the dramatic side. Spontaneous-onset of flushing episodes, during which some patients report “feeling on fire.” Frequent diarrhea that can hit anytime, anywhere. Difficulty breathing, which as any asthma sufferer can attest, induces a panicked feeling.

• #73 Malignant Carcinoid Syndrome Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/282515-clinical

  Carcinoid tumors grow slowly, and symptoms may not occur for several years, if at all. When symptoms do develop, they are ill defined and may be neglected for a long time before being properly diagnosed. In some cases, carcinoid tumors present as acute appendicitis or chronic pain in the lower right abdominal quadrant. For this reason, the condition is frequently misdiagnosed as irritable bowel syndrome. Alcohol intolerance and weight loss also may be associated manifestations. […] Severity of symptoms varies. Onset of symptoms may be spontaneous or may be precipitated by certain foods and beverages (eg, alcohol), pharmacologic agents, and physical or emotional stress. […] Diarrhea is common, as is flushing of the face and neck. These manifestations result from tumoral hormone production; however, some persons with carcinoid tumors that produce these molecules do not experience any symptoms.

• #74 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Wheezing and dyspnea occur in 10-20% of patients, often during flushing episodes. […] These are plaque-like deposits of fibrous tissue, most commonly found on valvular cusps or in cardiac chambers. […] Muscle wasting, retroperitoneal fibrosis leading to ureteral obstruction, and persistent facial edema. […] In the early stages of carcinoid syndrome, the symptoms are relatively nonspecific. The differential diagnoses for diarrhea, vague abdominal symptoms, and even flushing are rather broad. Patients are often given an initial diagnosis of irritable bowel syndrome, and only later does the true diagnosis become apparent. […] The median time from onset of symptoms attributable to the tumor and diagnosis is 9.2 years. […] Many of the major symptoms of carcinoid syndrome tend to be on the dramatic side. Spontaneous-onset of flushing episodes, during which some patients report “feeling on fire.” Frequent diarrhea that can hit anytime, anywhere. Difficulty breathing, which as any asthma sufferer can attest, induces a panicked feeling.

• #75 Carcinoid syndrome and carcinoid tumours | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/carcinoid-syndrome-and-carcinoid-tumours/

  Carcinoid syndrome is the collection of symptoms some people get when a carcinoid tumour usually one that has spread to the liver releases hormones such as serotonin into the bloodstream. […] Typical symptoms of carcinoid syndrome include: diarrhoea, tummy pain and loss of appetite, flushing of the skin, particularly the face, fast heart rate, breathlessness and wheezing. […] Some people may also develop carcinoid heart disease, where the heart valves thicken and stop working properly. There is also a risk of developing a rare but serious reaction called a carcinoid crisis, which involves severe flushing, breathlessness and a drop in blood pressure. […] Symptoms of carcinoid syndrome can be treated with injections of octreotide and lanreotide. You may also be given medication to widen your airways (to relieve wheezing and breathlessness) and anti-diarrhoea medication. […] But as the tumour grows or spreads, it will produce more and more hormones, and it may eventually be difficult to completely control symptoms with medication.

• #76 Malignant Carcinoid Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/282515-overview

  The main clinical characteristics of the carcinoids arising in the digestive tract that most often cause malignant carcinoid syndrome are described below. […] The prognosis for patients with malignant carcinoid syndrome is relatively good compared with the prognosis for patients with other malignancies, but the prognosis for any treated patient with progressing, recurring, or relapsing disease is poor. The median 5-year survival rate is 30-67%. […] The incidence of metastasis is estimated at 1-2 cases per 100,000 affected people. Lymph nodes and liver are the most common sites of metastasis, while bone and lung are less commonly affected. Involvement of distant sites (eg, ovary, orbit) is very rare. Risk of metastasis correlates with size of primary tumor, as follows: Tumors 1 cm metastasize in only 2% of cases; Tumors 1-2 cm metastasize in 50% of cases; Tumors 2 cm metastasize in 85% of cases.

• #77 Carcinoid syndrome: Causes and Management – DermNet

  https://dermnetnz.org/topics/carcinoid-syndrome

  Patients with carcinoid syndrome may experience long-term complications such as carcinoid heart disease, causing valve fibrosis, nutritional deficiencies, and neuropsychiatric manifestations. […] If all of the carcinoid tumours can be resected, then prognosis is excellent. If carcinoids have metastasised to the liver or other organs, and there is evidence of progressive, recurring or relapsing disease, then the prognosis is more guarded.

• #78 Malignant Carcinoid Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/282515-overview

  The main clinical characteristics of the carcinoids arising in the digestive tract that most often cause malignant carcinoid syndrome are described below. […] The prognosis for patients with malignant carcinoid syndrome is relatively good compared with the prognosis for patients with other malignancies, but the prognosis for any treated patient with progressing, recurring, or relapsing disease is poor. The median 5-year survival rate is 30-67%. […] The incidence of metastasis is estimated at 1-2 cases per 100,000 affected people. Lymph nodes and liver are the most common sites of metastasis, while bone and lung are less commonly affected. Involvement of distant sites (eg, ovary, orbit) is very rare. Risk of metastasis correlates with size of primary tumor, as follows: Tumors 1 cm metastasize in only 2% of cases; Tumors 1-2 cm metastasize in 50% of cases; Tumors 2 cm metastasize in 85% of cases.

• #79 Childhood Carcinoid Tumors | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/childhood-carcinoid-tumors

  A carcinoid tumor’s symptoms may vary from child to child. They will depend on the tumor location and type. The most common symptoms include: […] In rare cases, children may develop carcinoid syndrome, with symptoms such as redness in the face and neck, rapid heartbeat, difficulty breathing, a sudden drop in blood pressure, and diarrhea. These symptoms come from hormones produced by the tumor and rarely occur except in advanced cases. […] Your child’s outlook will likely depend on where the tumor is and whether it has spread. For tumors growing in the appendix, an appendectomy is often the only thing needed to remove the tumor altogether. In this situation, a child’s prognosis is excellent. Larger tumors in other locations or those that have spread throughout the body are more difficult to treat and may require surgery, chemotherapy, radiation therapy, or other therapies or interventions.

• #80 Malignant Carcinoid Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/282515-overview

  The main clinical characteristics of the carcinoids arising in the digestive tract that most often cause malignant carcinoid syndrome are described below. […] The prognosis for patients with malignant carcinoid syndrome is relatively good compared with the prognosis for patients with other malignancies, but the prognosis for any treated patient with progressing, recurring, or relapsing disease is poor. The median 5-year survival rate is 30-67%. […] The incidence of metastasis is estimated at 1-2 cases per 100,000 affected people. Lymph nodes and liver are the most common sites of metastasis, while bone and lung are less commonly affected. Involvement of distant sites (eg, ovary, orbit) is very rare. Risk of metastasis correlates with size of primary tumor, as follows: Tumors 1 cm metastasize in only 2% of cases; Tumors 1-2 cm metastasize in 50% of cases; Tumors 2 cm metastasize in 85% of cases.

• #81 Gastrointestinal Neuroendocrine Tumors and Carcinoid Syndrome – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors-nets/gastrointestinal-neuroendocrine-tumors-and-carcinoid-syndrome

  Somatostatin analogs such as octreotide or longer-acting lanreotide may help control symptoms. […] Surgical resection may be curative in the absence of metastases. […] Surgical debulking, image-guided ablation, bland embolization, chemoembolization, or radioembolization may help relieve symptoms and possibly prolong survival in patients with hepatic metastases. […] Prognosis of neuroendocrine tumors depends on primary site, grade, and stage. Despite metastatic disease and the carcinoid syndrome that can accompany it, NETs are slow growing, and survival of 10 to 15 years is not unusual.

• #82 Carcinoid Syndrome due to Neuroendocrine Tumors – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors/carcinoid-syndrome-due-to-neuroendocrine-tumors

  People with carcinoid syndrome usually have flushing and sometimes diarrhea. […] The most common, and often earliest symptom of carcinoid syndrome is uncomfortable flushing, typically of the head and neck. […] Excessive contraction of the intestine may result in abdominal cramping and diarrhea. The intestine may not be able to absorb nutrients properly, resulting in undernutrition and fatty, foul-smelling stools. […] Heart damage may occur, which can result in symptoms of right heart failure such as swelling of the feet and legs (edema). […] Wheezing and shortness of breath may result from blockage of airflow in the lungs. […] Some people with carcinoid syndrome lose interest in sex, and some men have erectile dysfunction. […] Fewer than 10% of people with neuroendocrine tumors develop symptoms of carcinoid syndrome, although this percentage varies depending on where the tumor is located. […] Neuroendocrine tumors grow so slowly that even people whose tumors have spread often survive for 10 to 15 years.

• #83 Carcinoid syndrome and carcinoid tumours | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/carcinoid-syndrome-and-carcinoid-tumours/

  Carcinoid syndrome is the collection of symptoms some people get when a carcinoid tumour usually one that has spread to the liver releases hormones such as serotonin into the bloodstream. […] Typical symptoms of carcinoid syndrome include: diarrhoea, tummy pain and loss of appetite, flushing of the skin, particularly the face, fast heart rate, breathlessness and wheezing. […] Some people may also develop carcinoid heart disease, where the heart valves thicken and stop working properly. There is also a risk of developing a rare but serious reaction called a carcinoid crisis, which involves severe flushing, breathlessness and a drop in blood pressure. […] Symptoms of carcinoid syndrome can be treated with injections of octreotide and lanreotide. You may also be given medication to widen your airways (to relieve wheezing and breathlessness) and anti-diarrhoea medication. […] But as the tumour grows or spreads, it will produce more and more hormones, and it may eventually be difficult to completely control symptoms with medication.

• #84 Carcinoid syndrome: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000347.htm

  Carcinoid syndrome is a group of symptoms associated with carcinoid tumors. These tumors release too much of the hormone serotonin, as well as several other chemicals. These hormones cause the blood vessels to open (dilate). This causes carcinoid syndrome. […] The carcinoid syndrome is made up of four main symptoms including: Flushing (face, neck, or upper chest), or widened blood vessels seen on the skin (telangiectasias), Difficulty breathing, such as wheezing, Diarrhea, Heart problems, such as leaking heart valves, blood pressure changes, and heart palpitations. […] Symptoms are sometimes brought on by physical exertion, or eating or drinking things such as blue cheese, chocolate, or red wine. […] In people with carcinoid syndrome, the tumor has usually spread to the liver. This lowers the survival rate. Overall, the prognosis is usually poor.

• #85 Carcinoid Tumors | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0801/p429.html

  The prognosis for patients with these tumors is variable and related to the site of the primary tumor, the presence of metastatic disease, and time of diagnosis. Importantly, the most common cause of carcinoid syndrome is metastatic liver disease arising from a small bowel carcinoid tumor. For these patients, the prognosis is uniformly poor.

• #86 Carcinoid Syndrome Symptoms — The Healing NET Foundation

  https://www.thehealingnet.org/net-medical-care/2021/6/29/managing-carcinoid-syndrome-the-5-es

  EATING Large meals, spicy foods, and foods high in nitrogen-containing compounds called amines can trigger symptoms of carcinoid syndrome. Tomato-based foods, caffeine, chocolate, nuts and raw vegetables are common triggers. […] EXERCISE This trigger is highly variable from person to person, but in general physical stress may activate symptoms. The trick here is not to overdo. If you are not used to a particular exercise regimen, take it slowly and work up your tolerance. […] EMOTIONS Strong emotions such as anger, stress and anxiety can trigger symptoms. While it is impossible to completely avoid stress in everyday life, patients with carcinoid syndrome should work to reduce stress levels. […] EPINEPHRINE Certain medical or dental procedures may require numbing agents or anesthetics, which could contain epinephrine. In small doses it is usually quite safe, but epinephrine could trigger symptoms. Inform providers of your carcinoid syndrome diagnosis so they are aware and can consider alternatives.

• #87 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/about-carcinoid-syndrome

  Some neuroendocrine tumours (NETs) make large amounts of hormones and proteins. The most common substance they make is serotonin. They sometimes release serotonin and the other proteins into the bloodstream. This can cause a collection of symptoms called carcinoid syndrome. […] Carcinoid syndrome is most common in people with a small bowel NET which has spread to the liver. It can also happen in people with lung and pancreatic NETs. But this is less common. […] The main symptoms of carcinoid syndrome are: […] Flushing of the skin. The skin of your face, neck and chest might look red (flushed). It may also feel warm and itchy. 85 out of every 100 people (85%) with carcinoid syndrome have this symptom. Flushing of the skin is often unexpected and unpredictable. Some people find there are triggers. For example, certain foods, drinking coffee or alcohol, stress or exercise.

• #88 Signs and Symptoms of Gastrointestinal Carcinoid Tumors | American Cancer Society

  https://www.cancer.org/cancer/types/gastrointestinal-carcinoid-tumor/detection-diagnosis-staging/signs-symptoms.html

  Most gastrointestinal (GI) carcinoids grow slowly. If they do cause symptoms, they tend to be vague. […] A tumor usually has to grow fairly large before it completely blocks (obstructs) the intestine and causes severe belly pain, nausea and vomiting, and a potentially life-threatening situation. […] About 1 out of 10 carcinoid tumors release enough hormone-like substances into the bloodstream to cause carcinoid syndrome symptoms. These include: Facial flushing (redness and warm feeling), Severe diarrhea, Wheezing, Fast heartbeat. […] Many people find that factors such as stress, heavy exercise, and drinking alcohol trigger these symptoms. Over a long time, these hormone-like substances can damage heart valves, causing shortness of breath, weakness, and a heart murmur (an abnormal heart sound). […] Most cases of carcinoid syndrome occur only after the cancer has already spread to other parts of the body. Carcinoid tumors in the midgut (appendix, small intestine, cecum and ascending colon) that spread to the liver are most likely to cause carcinoid syndrome.

• #89 Carcinoid Syndrome Symptoms — The Healing NET Foundation

  https://www.thehealingnet.org/net-medical-care/2021/6/29/managing-carcinoid-syndrome-the-5-es

  EATING Large meals, spicy foods, and foods high in nitrogen-containing compounds called amines can trigger symptoms of carcinoid syndrome. Tomato-based foods, caffeine, chocolate, nuts and raw vegetables are common triggers. […] EXERCISE This trigger is highly variable from person to person, but in general physical stress may activate symptoms. The trick here is not to overdo. If you are not used to a particular exercise regimen, take it slowly and work up your tolerance. […] EMOTIONS Strong emotions such as anger, stress and anxiety can trigger symptoms. While it is impossible to completely avoid stress in everyday life, patients with carcinoid syndrome should work to reduce stress levels. […] EPINEPHRINE Certain medical or dental procedures may require numbing agents or anesthetics, which could contain epinephrine. In small doses it is usually quite safe, but epinephrine could trigger symptoms. Inform providers of your carcinoid syndrome diagnosis so they are aware and can consider alternatives.

• #90 Carcinoid Tumor | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/carcinoid-tumor.html

  Carcinoid tumors are also called neuroendocrine tumors. It’s a rare type of cancer. Carcinoid tumors tend to grow slowly. Few people with these tumors have symptoms. So you may have a carcinoid tumor for many years and never know it. […] In rare cases, a functional carcinoid tumor can cause a group of symptoms called carcinoid syndrome. This tends to happen after the tumor has spread. The symptoms may be triggered by exercise, stress, or certain foods and drinks, like alcohol (especially red wine), walnuts, pecans, bananas, tofu, and aged cheeses. These are common symptoms: Your face gets red (flushed), Cramps, Diarrhea, Nausea or vomiting, Asthma-like breathing problems, Shortness of breath, Fainting, Fast heart rate (palpitations), Blood pressure changes, Right-sided valvular heart disease in some people. […] In rare cases, a carcinoid tumor can cause a group of symptoms called carcinoid syndrome. This often happens after the tumor has spread.

• #91 Carcinoid Cancer: Definition, Symptoms, Prognosis, and More

  https://www.verywellhealth.com/carcinoid-syndrome-overview-and-more-5213355

  Carcinoid syndrome develops from tumors that produce hormones. It occurs in about 10% of people with a carcinoid tumor. […] Symptoms of carcinoid syndrome include: Facial flushing (warmth and redness of the face, head, and upper chest), Nausea/vomiting, Diarrhea, Heart palpitations, Fainting, Wheezing, Change in blood pressure (usually a decrease or low blood pressure), Change in weight (gain or loss), Malnutrition, Dehydration, Weakness, Aching in muscles and joints, Peptic ulcer. […] Symptoms can happen spontaneously or be triggered by factors such as: Exercise, Some drinks, such as alcohol (particularly red wine), Stress, Some foods, such as chocolate and certain cheeses.

• #92 Carcinoid Syndrome Symptoms — The Healing NET Foundation

  https://www.thehealingnet.org/net-medical-care/2021/6/29/managing-carcinoid-syndrome-the-5-es

  EATING Large meals, spicy foods, and foods high in nitrogen-containing compounds called amines can trigger symptoms of carcinoid syndrome. Tomato-based foods, caffeine, chocolate, nuts and raw vegetables are common triggers. […] EXERCISE This trigger is highly variable from person to person, but in general physical stress may activate symptoms. The trick here is not to overdo. If you are not used to a particular exercise regimen, take it slowly and work up your tolerance. […] EMOTIONS Strong emotions such as anger, stress and anxiety can trigger symptoms. While it is impossible to completely avoid stress in everyday life, patients with carcinoid syndrome should work to reduce stress levels. […] EPINEPHRINE Certain medical or dental procedures may require numbing agents or anesthetics, which could contain epinephrine. In small doses it is usually quite safe, but epinephrine could trigger symptoms. Inform providers of your carcinoid syndrome diagnosis so they are aware and can consider alternatives.

• #93 Carcinoid Crisis and Anaesthesia: Signs, Risks, Triggers & More

  https://neuroendocrine.org.au/treatments/carcinoid-crisis-and-anaesthesia/

  Different things can set off a carcinoid crisis, like: Surgeries and specific treatments, Feeling anxious or stressed, Receiving anaesthesia, Feeling very cold during surgery, Taking certain drugs that can cause a reaction. […] Its hard to predict which patients might be at risk for a carcinoid crisis during surgery. […] To help prevent and manage a carcinoid crisis, a medicine called octreotide is used. It stops certain hormones from being released and slows down tumour growth. […] Patients who are at risk of carcinoid crisis should engage in open and proactive communication with their healthcare team to ensure their safety and well-being. If youve had a recent NET diagnosis, it is vital to inform your healthcare providers about your specific medical history, including any previous episodes of carcinoid crisis, triggers, and symptoms youve experienced. […] Establish a clear action plan with your healthcare team, which includes instructions on how to recognise the early signs of a carcinoid crisis and what immediate steps to take if one occurs.

• #94 Carcinoid Syndrome Symptoms — The Healing NET Foundation

  https://www.thehealingnet.org/net-medical-care/2021/6/29/managing-carcinoid-syndrome-the-5-es

  EATING Large meals, spicy foods, and foods high in nitrogen-containing compounds called amines can trigger symptoms of carcinoid syndrome. Tomato-based foods, caffeine, chocolate, nuts and raw vegetables are common triggers. […] EXERCISE This trigger is highly variable from person to person, but in general physical stress may activate symptoms. The trick here is not to overdo. If you are not used to a particular exercise regimen, take it slowly and work up your tolerance. […] EMOTIONS Strong emotions such as anger, stress and anxiety can trigger symptoms. While it is impossible to completely avoid stress in everyday life, patients with carcinoid syndrome should work to reduce stress levels. […] EPINEPHRINE Certain medical or dental procedures may require numbing agents or anesthetics, which could contain epinephrine. In small doses it is usually quite safe, but epinephrine could trigger symptoms. Inform providers of your carcinoid syndrome diagnosis so they are aware and can consider alternatives.

• #95 Carcinoid Syndrome Symptoms — The Healing NET Foundation

  https://www.thehealingnet.org/net-medical-care/2021/6/29/managing-carcinoid-syndrome-the-5-es

  ETHANOL (ALCOHOL) Some people cannot tolerate any alcohol because it can exacerbate carcinoid syndrome. Monitor your own reaction and adjust accordingly. […] Finding ways to cope with the anxiety and worry that can accompany carcinoid syndrome may aid in decreasing symptoms and how much they affect your life. Incorporating self care activities to reduce stress, such as journaling, enjoying your favorite hobby, spending quality time with loved ones, meditation and/or just resting and pausing when needed, can make a difference. These things, coupled with your medical interventions, can greatly improve your quality of life.

• #96 Carcinoid Syndrome Symptoms — The Healing NET Foundation

  https://www.thehealingnet.org/net-medical-care/2021/6/29/managing-carcinoid-syndrome-the-5-es

  EATING Large meals, spicy foods, and foods high in nitrogen-containing compounds called amines can trigger symptoms of carcinoid syndrome. Tomato-based foods, caffeine, chocolate, nuts and raw vegetables are common triggers. […] EXERCISE This trigger is highly variable from person to person, but in general physical stress may activate symptoms. The trick here is not to overdo. If you are not used to a particular exercise regimen, take it slowly and work up your tolerance. […] EMOTIONS Strong emotions such as anger, stress and anxiety can trigger symptoms. While it is impossible to completely avoid stress in everyday life, patients with carcinoid syndrome should work to reduce stress levels. […] EPINEPHRINE Certain medical or dental procedures may require numbing agents or anesthetics, which could contain epinephrine. In small doses it is usually quite safe, but epinephrine could trigger symptoms. Inform providers of your carcinoid syndrome diagnosis so they are aware and can consider alternatives.

• #97 Carcinoid syndrome: Causes and Management – DermNet

  https://dermnetnz.org/topics/carcinoid-syndrome

  Carcinoid syndrome is characterised by episodic cutaneous flushing, diarrhoea, and wheezing. […] Carcinoid symptoms are more common in those with bowel tumours, particularly when they have spread to the liver. […] The main cutaneous feature of carcinoid syndrome is flushing, which occurs in 75% of cases. This is caused by transient dilation of blood vessels. […] Flushing could be spontaneous or triggered by psychological stress, physical stress, infection, alcohol, food items which are either spicy or rich in amines, and medications. […] Carcinoid syndrome may also cause other symptoms such as weight loss, low blood pressure, and abdominal pain. […] Carcinoid syndrome can cause carcinoid crisis, which involves cutaneous flushing, hypotension, tachycardia/arrhythmias, bronchospasm, and/or sometimes hyperthermia.

• #98 Carcinoid syndrome: update on the pathophysiology and treatment | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-carcinoid-syndrome-update-on-pathophysiology-S1807593222011310

  Approximately 30-40% of patients with well-differentiated neuroendocrine tumors present with carcinoid syndrome, which is a paraneoplastic syndrome associated with the secretion of several humoral factors. […] Carcinoid syndrome significantly and negatively affects patients’ quality of life; increases costs compared with the costs of nonfunctioning neuroendocrine tumors; and results in changes in patients’ lifestyle, such as diet, work, physical activity and social life. […] The main symptoms of CS are episodic facial flushing that may be accompanied by hypotension and tachycardia, diarrhea, bronchoconstriction, venous telangiectasia, dyspnea and ultimately fibrotic complications such as mesenteric and retroperitoneal fibroses and carcinoid heart disease. […] CS also significantly and negatively affects patients’ quality of life; increases costs compared with the costs of nonfunctioning NETs; and results in changes in the patients’ lifestyle, such as diet, work, physical activity and social life.

• #99 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  These daily challenges often cause a great deal of stress for patients. Not knowing where, why, or when the next episode will hit can severely inhibit social interaction, which can lead to a sense of isolation. […] Because it is so rare, carcinoid syndrome is often not detected or even suspected when someone presents with symptoms. Keeping it in mind as a possibility will go a long way to getting patients the treatment they need, sooner. […] The degree of success depends on tumor size and location. […] Somatostatin is a peptide that inhibits the secretion of a broad range of hormones in the body by binding to receptors on the surface of certain cells. Because nearly 80% of well-differentiated gastrointestinal NETs express somatostatin receptors, a class of drugs called somatostatin analogs are one of the first avenues for treatment of carcinoid syndrome. […] Flushing and diarrhea improve significantly in over 80% of patients undergoing this therapy. […] Depending on the patient’s response, a combination of therapies may be used.

• #100 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  These daily challenges often cause a great deal of stress for patients. Not knowing where, why, or when the next episode will hit can severely inhibit social interaction, which can lead to a sense of isolation. […] Because it is so rare, carcinoid syndrome is often not detected or even suspected when someone presents with symptoms. Keeping it in mind as a possibility will go a long way to getting patients the treatment they need, sooner. […] The degree of success depends on tumor size and location. […] Somatostatin is a peptide that inhibits the secretion of a broad range of hormones in the body by binding to receptors on the surface of certain cells. Because nearly 80% of well-differentiated gastrointestinal NETs express somatostatin receptors, a class of drugs called somatostatin analogs are one of the first avenues for treatment of carcinoid syndrome. […] Flushing and diarrhea improve significantly in over 80% of patients undergoing this therapy. […] Depending on the patient’s response, a combination of therapies may be used.

• #101 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Carcinoid heart disease happens when there is a build up of plaque or scar tissue in the heart valves and the heart muscle. Over time, the valves become thicker and this can affect how the heart works. Carcinoid heart disease happens in up to 50 out of every 100 people with carcinoid syndrome (up to 50%). Symptoms of carcinoid heart disease are usually vague. Most people don’t have any symptoms until it is severe. Symptoms include: feeling breathless; tiredness (fatigue); a build up of fluid in your body causing swelling; weight loss. […] It can be difficult to cope with carcinoid syndrome and its complications. You might have ongoing symptoms such as diarrhoea and flushing of the skin that are difficult to control.

• #102 Understanding Carcinoid Tumor Behavior

  https://www.curetoday.com/view/understanding-carcinoid-tumor-behavior

  The flushing I had was, in some instances, intense enough to create nausea, vomiting, chest pain, sweating, and absolute loss of energy for several hours. In other cases, the flushing was fairly mild. Accompanying the flushing, I had pretty significant diarrhea. […] Different people seem to manifest the symptoms in different ways. We know that there are probably different hormones that account for some of the symptoms. Serotonin is very well linked to the diarrhea. […] Its very common to have both of them, to tell you the truth. […] In many ways, its an extreme episode of having carcinoid syndrome. Its when large amounts of serotonin, and probably some of the other hormones made by these tumors, are released suddenly in response to a stimulus. […] Carcinoid crisis is often a scenario where people have very high blood pressures and then theyll have sudden plummeting of their blood pressure. Some people with get severely bronchospastic and hypoxicthat means low oxygenmdash;during that.

• #103 Carcinoid syndrome in neuroendocrine tumours (NETs)| Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/neuroendocrine-tumours-nets/carcinoid-syndrome/complications

  Carcinoid heart disease happens when there is a build up of plaque or scar tissue in the heart valves and the heart muscle. Over time, the valves become thicker and this can affect how the heart works. Carcinoid heart disease happens in up to 50 out of every 100 people with carcinoid syndrome (up to 50%). Symptoms of carcinoid heart disease are usually vague. Most people don’t have any symptoms until it is severe. Symptoms include: feeling breathless; tiredness (fatigue); a build up of fluid in your body causing swelling; weight loss. […] It can be difficult to cope with carcinoid syndrome and its complications. You might have ongoing symptoms such as diarrhoea and flushing of the skin that are difficult to control.

• #104 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  These daily challenges often cause a great deal of stress for patients. Not knowing where, why, or when the next episode will hit can severely inhibit social interaction, which can lead to a sense of isolation. […] Because it is so rare, carcinoid syndrome is often not detected or even suspected when someone presents with symptoms. Keeping it in mind as a possibility will go a long way to getting patients the treatment they need, sooner. […] The degree of success depends on tumor size and location. […] Somatostatin is a peptide that inhibits the secretion of a broad range of hormones in the body by binding to receptors on the surface of certain cells. Because nearly 80% of well-differentiated gastrointestinal NETs express somatostatin receptors, a class of drugs called somatostatin analogs are one of the first avenues for treatment of carcinoid syndrome. […] Flushing and diarrhea improve significantly in over 80% of patients undergoing this therapy. […] Depending on the patient’s response, a combination of therapies may be used.

• #105 Carcinoid syndrome: update on the pathophysiology and treatment | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-carcinoid-syndrome-update-on-pathophysiology-S1807593222011310

  Approximately 30-40% of patients with well-differentiated neuroendocrine tumors present with carcinoid syndrome, which is a paraneoplastic syndrome associated with the secretion of several humoral factors. […] Carcinoid syndrome significantly and negatively affects patients’ quality of life; increases costs compared with the costs of nonfunctioning neuroendocrine tumors; and results in changes in patients’ lifestyle, such as diet, work, physical activity and social life. […] The main symptoms of CS are episodic facial flushing that may be accompanied by hypotension and tachycardia, diarrhea, bronchoconstriction, venous telangiectasia, dyspnea and ultimately fibrotic complications such as mesenteric and retroperitoneal fibroses and carcinoid heart disease. […] CS also significantly and negatively affects patients’ quality of life; increases costs compared with the costs of nonfunctioning NETs; and results in changes in the patients’ lifestyle, such as diet, work, physical activity and social life.

• #106 Carcinoid Syndrome – Living with NETS

  https://www.livingwithnets.com/about-neuroendocrine-tumours-nets/learn-about-nets/carcinoid-syndrome/

  Untreated carcinoid syndrome can result in vitamin deficiencies and regular bouts of diarrhoea, which can cause dehydration. […] Carcinoid syndrome can be treated using hormone therapy with a somatostatin analogue to lessen diarrhoea and skin flushing. […] An excess of serotonin can cause carcinoid syndrome. One key symptom of carcinoid syndrome is diarrhoea which can be lessened by taking a medication that reduces the activity of TPH (a TPH inhibitor). […] Liver metastases are the main source of hormones released into the bloodstream in some patients with NETs. Thus treatments that are directed at the liver may help to reduce symptoms of carcinoid syndrome if other methods have not worked. […] In some cases, surgery to remove some, if not all, liver metastases due to NETs can reduce the bulk of NET cells releasing hormones if other treatments have not worked (sometimes called debulking). This type of surgery reduces the volume of NET cells which in turn should help to reduce the production of hormones that cause the symptoms of carcinoid syndrome.

• #107 Carcinoid syndrome: update on the pathophysiology and treatment | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-carcinoid-syndrome-update-on-pathophysiology-S1807593222011310

  While these agents provide significant relief from CS symptoms, there is inevitable clinical progression, when new therapeutic interventions are needed. […] Symptoms of right heart failure, such as peripheral edema, abdominal discomfort and indigestion, early satiety and cachexia, appear during the course of its evolution. As the condition worsens, fatigue, dyspnea upon exertion, jugular swelling, and ascites are observed. If these symptoms are not treated, progression of the manifestations leads to death from heart failure. […] Mesenteric fibrosis (MF) is another complication of uncontrolled CS. At least some signs of MF occur in approximately 50% of CS patients. […] The diagnosis of CS requires the combination of carcinoid symptoms and evidence of elevated levels of 5-HIAA in a 24-h urine sample. […] Unfortunately, all patients experience symptomatic progression of CS after a median of several months to years.

• #108 Carcinoid Syndrome: Symptoms, Causes, Treatment, Diet, Prognosis

  https://www.healthline.com/health/carcinoid-syndrome

  As carcinoid syndrome progresses, it can lead to: drop in blood pressure, malnutrition, weight loss or gain, dehydration or electrolyte imbalance, peptic ulcer, damage to heart valves, heart murmur, heart failure, blocked arteries in the liver, bowel obstruction. […] In extremely rare cases, acute symptoms such as low blood pressure, palpitations, faintness, and shortness of breath may become life-threatening. This is called carcinoid crisis. In some people, these symptoms are triggered by stress, intense exercise, or alcohol. […] Carcinoid syndrome usually occurs with advanced carcinoid cancer, or cancer that’s metastasized to a distant site.

• #109 Carcinoid Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448096/

  Carcinoid syndrome is a rare clinical condition caused by metastatic, well-differentiated neuroendocrine tumors, primarily originating in the midgut and associated with liver metastases. These tumors secrete biogenic amines, particularly serotonin, leading to hallmark symptoms such as flushing, diarrhea, bronchospasm, and systemic complications like carcinoid heart disease. Flushing, often triggered by stress, food, or alcohol, and diarrhea, is frequently chronic and debilitating. […] Carcinoid syndrome arises from the release of biologically active amines and peptides into the systemic circulation, bypassing the liver’s first-pass metabolism. The liver normally inactivates these substances, but liver metastases from neuroendocrine tumors can allow these products to enter the circulation and exert systemic effects.

• #110 Carcinoid syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Carcinoid_syndrome

  Carcinoid syndrome is a paraneoplastic syndrome comprising the signs and symptoms that occur secondary to neuroendocrine tumors (formerly known as carcinoid tumors). The syndrome is caused by neuroendocrine tumors most often found in the gut releasing biologically active substances into the blood causing symptoms such as flushing and diarrhea, and less frequently, heart failure, vomiting and bronchoconstriction. […] The carcinoid syndrome occurs in approximately 10% of all neuroendocrine tumors or about 30-40% of more advanced/well developed neuroendocrine tumors. The biologically active substances that are released by the tumors cause the symptoms of the carcinoid syndrome. These substances act on the vessels to produce the symptoms of the carcinoid syndrome. […] Flushing: The most common finding is flushing of the skin, usually of the head and the upper part of thorax in about 85% of people. The flushing may come and go and may also be triggered by various factors such as diet (i.e. alcohol intake), activity, and stress.

• #111 Carcinoid syndrome – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/296

  Carcinoid syndrome commonly presents with flushing and diarrhoea. Other clinical features include wheeze, palpitations, telangiectasia, and abdominal pain. […] Symptoms develop due to secretion of serotonin, kinins, and other biogenic amines from functional secretory neuroendocrine tumours. […] The principal features of carcinoid syndrome are diarrhoea and flushing. Wheezing, telangiectasia, and abdominal pain can also occur. […] Complications include carcinoid heart disease and carcinoid crisis at times of stress (e.g., during surgery).

• #112 Carcinoid Syndrome, Symptoms, Diagnosis, Treatment

  https://crinetics.com/carcinoid-syndrome-symptoms-diagnosis-treatment/

  Wheezing and dyspnea occur in 10-20% of patients, often during flushing episodes. […] These are plaque-like deposits of fibrous tissue, most commonly found on valvular cusps or in cardiac chambers. […] Muscle wasting, retroperitoneal fibrosis leading to ureteral obstruction, and persistent facial edema. […] In the early stages of carcinoid syndrome, the symptoms are relatively nonspecific. The differential diagnoses for diarrhea, vague abdominal symptoms, and even flushing are rather broad. Patients are often given an initial diagnosis of irritable bowel syndrome, and only later does the true diagnosis become apparent. […] The median time from onset of symptoms attributable to the tumor and diagnosis is 9.2 years. […] Many of the major symptoms of carcinoid syndrome tend to be on the dramatic side. Spontaneous-onset of flushing episodes, during which some patients report “feeling on fire.” Frequent diarrhea that can hit anytime, anywhere. Difficulty breathing, which as any asthma sufferer can attest, induces a panicked feeling.

• #113 Carcinoid syndrome: update on the pathophysiology and treatment | Clinics

  https://www.elsevier.es/en-revista-clinics-22-articulo-carcinoid-syndrome-update-on-pathophysiology-S1807593222011310

  Approximately 30-40% of patients with well-differentiated neuroendocrine tumors present with carcinoid syndrome, which is a paraneoplastic syndrome associated with the secretion of several humoral factors. […] Carcinoid syndrome significantly and negatively affects patients’ quality of life; increases costs compared with the costs of nonfunctioning neuroendocrine tumors; and results in changes in patients’ lifestyle, such as diet, work, physical activity and social life. […] The main symptoms of CS are episodic facial flushing that may be accompanied by hypotension and tachycardia, diarrhea, bronchoconstriction, venous telangiectasia, dyspnea and ultimately fibrotic complications such as mesenteric and retroperitoneal fibroses and carcinoid heart disease. […] CS also significantly and negatively affects patients’ quality of life; increases costs compared with the costs of nonfunctioning NETs; and results in changes in the patients’ lifestyle, such as diet, work, physical activity and social life.

• #114 Carcinoid Syndrome due to Neuroendocrine Tumors – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors/carcinoid-syndrome-due-to-neuroendocrine-tumors

  People with carcinoid syndrome usually have flushing and sometimes diarrhea. […] The most common, and often earliest symptom of carcinoid syndrome is uncomfortable flushing, typically of the head and neck. […] Excessive contraction of the intestine may result in abdominal cramping and diarrhea. The intestine may not be able to absorb nutrients properly, resulting in undernutrition and fatty, foul-smelling stools. […] Heart damage may occur, which can result in symptoms of right heart failure such as swelling of the feet and legs (edema). […] Wheezing and shortness of breath may result from blockage of airflow in the lungs. […] Some people with carcinoid syndrome lose interest in sex, and some men have erectile dysfunction. […] Fewer than 10% of people with neuroendocrine tumors develop symptoms of carcinoid syndrome, although this percentage varies depending on where the tumor is located. […] Neuroendocrine tumors grow so slowly that even people whose tumors have spread often survive for 10 to 15 years.

• #115 Gastrointestinal Neuroendocrine Tumors and Carcinoid Syndrome – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/gastrointestinal-and-pancreatic-neuroendocrine-tumors-nets/gastrointestinal-neuroendocrine-tumors-and-carcinoid-syndrome

  Somatostatin analogs such as octreotide or longer-acting lanreotide may help control symptoms. […] Surgical resection may be curative in the absence of metastases. […] Surgical debulking, image-guided ablation, bland embolization, chemoembolization, or radioembolization may help relieve symptoms and possibly prolong survival in patients with hepatic metastases. […] Prognosis of neuroendocrine tumors depends on primary site, grade, and stage. Despite metastatic disease and the carcinoid syndrome that can accompany it, NETs are slow growing, and survival of 10 to 15 years is not unusual.

• #116 Malignant Carcinoid Syndrome: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/282515-overview

  The main clinical characteristics of the carcinoids arising in the digestive tract that most often cause malignant carcinoid syndrome are described below. […] The prognosis for patients with malignant carcinoid syndrome is relatively good compared with the prognosis for patients with other malignancies, but the prognosis for any treated patient with progressing, recurring, or relapsing disease is poor. The median 5-year survival rate is 30-67%. […] The incidence of metastasis is estimated at 1-2 cases per 100,000 affected people. Lymph nodes and liver are the most common sites of metastasis, while bone and lung are less commonly affected. Involvement of distant sites (eg, ovary, orbit) is very rare. Risk of metastasis correlates with size of primary tumor, as follows: Tumors 1 cm metastasize in only 2% of cases; Tumors 1-2 cm metastasize in 50% of cases; Tumors 2 cm metastasize in 85% of cases.

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