Words and Terms That May Be Unfamiliar...

Important terms for you to know:

  Carcinoid Syndrome

A combination of symptoms caused by release into the circulation of excessive amounts of serotonin and other hormonal substances from some carcinoid tumors.

Symptoms may include flushing of the face, diarrhea, bronchial spasms (wheezing), rapid pulse, and sudden blood pressure changes (usually a fall) along with other symptoms of heart failure. Carcinoid syndrome is often mistaken for common diseases including irritable bowel syndrome, peptic ulcer, lupus, asthma, or menopause.

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 Carcinoid Heart Disease

Cardiac manifestation of malignant carcinoid syndrome.  It is a unique form of fibrosis involving the endocardium, primarily of the right heart. The fibrous deposits tend to cause constriction of the tricuspid and pulmonary valves. Serotonin excretion plays a role in the development of carcinoid heart disease (CHD), but the exact pathogenesis is not known.



Important terms for you to know:

 Carcinoid Crisis

A carcinoid crisis may be prevented and successfully treated with octreotide, a therapy that can increase low blood pressure and control the production of hormones.

Carcinoid crisis and pseudoanaphylactic reactions: Carcinoid crisis is when all ofthe symptoms of carcinoid syndrome come at the same time. Carcinoid crisis is themost serious and life-threatening complication of carcinoid syndrome, and isgenerally found in people who already have carcinoid syndrome. The crisis mayoccur suddenly, or it can be associated with stress, chemotherapy, or anesthesia. It is characterized by abrupt flushing of face and sometimes-upper body, usuallysevere falls in blood pressure and even bronchospasm with wheezing can(infrequently) occur. The attack may look like an anaphylactic attack. Diarrhea is animportant part of carcinoid syndrome but is not usually simultaneous with thecarcinoid crisis. It more commonly occurs as part of the anaphylactic reaction of anallergic or pseudo-allergic reaction. Standard allergy tests are not usually positive insuch cases. 24-hour urine histamine, blood histamine and blood tryptase tests, particularly if obtained at time of attack or just afterward will establish diagnosis. Of allergic or pseudoallergic [so called idiopathic] anaphylactic attacks and mast cell disease.

Epinephrine will provoke - not help carcinoid crisis attacks.

Urine 5HIAA is helpful when positive but if depended on as the sole chemical test for carcinoid syndrome will miss 50% of cases! Better also to measure blood serotonin, tryptophan and chromogranin A. Other blood markers associated with rare cases of severe attacks of flushing, diarrhea and fall in blood pressure are VIP, calcitonin and gastrin. They too should be measured. If any of all of the above are positive, further elaborate tests and treatment will be needed with details depending on which test(s) are positive.