carcinoid tumor

Carcinoid tumors are a type of neuroendocrine tumor that can occur in a number of locations. Carcinoid tumors arise from endocrine amine precursor uptake and decarboxylation (APUD) cells that can be found throughout the gastrointestinal tract as well as other organs (e.g. lung). In general, they are slow-growing tumors but are nevertheless capable of metastasizing.

Clinical presentation

• can be variable, dependent on the location:
  • carcinoid tumors involving the jejunum and ileum can be large at presentation but are usually found incidentally
  • rectal carcinoids may cause pain
  • gastrointestinal tract carcinoid can present as vague abdominal pain
• carcinoid syndrome: in 8% of patients with a carcinoid tumor

Pathology

Location

• gastrointestinal tract carcinoid (60-85% of all carcinoids)
  • small bowel: ~40% of gastrointestinal carcinoids, mostly in the terminal ileum
  • rectum (~22.5%)
  • colon (~15%)
  • appendix (~10%)
  • stomach (~7.5%)
  • pancreas (~7.5%)
• carcinoid tumors of the lung (~25% of all carcinoids)
  • bronchial carcinoid
  • peripheral pulmonary carcinoid tumors
• primary hepatic carcinoid
• ovarian carcinoid: accounts for 0.5% of carcinoid tumors and 0.3% of ovarian tumors
• thymic carcinoid

Markers

• 5-HIAA (5-hydroxyindoleacetic acid): usually suggests a functioning carcinoid tumor
• chromogranin A (CgA): considered a valuable tool in the diagnosis of neuroendocrine neoplasia in general

Radiographic features

CT/MRI

Refer to specific articles (above) for imaging characteristics.

Nuclear medicine

• gallium-68 octreotide PET/CT (e.g. Ga-68 DOTATATE) has shown improved accuracy for detection of neuroendocrine tumors relative to indium-111 pentetreotide (Octreoscan) SPECT/CT 
• indium-111 octreotide (e.g. Octreoscan) SPECT/CT
• iodine-123 MIBG will also concentrate on carcinoid tumors, including the low percentage (~15%) that are negative with indium-111 octreotide

Treatment and prognosis

Complications

• cardiac valve lesions from carcinoid

History and etymology

It was initially coined by Oberndorfer in 1907 as “karzinoide” to denote its resemblance to carcinoma .

Siehe auch:

• bronchial carcinoid
• Dünndarmkarzinoid
• Somatostatin-Rezeptor-Szintigrafie
• carcinoid tumours of lung
• peripheral pulmonary carcinoid tumours
• midgut carcinoid tumor
• Karzinoidsyndrom
• Karzinoid des Thymus
• carcinoid of the appendix
• carcinoid tumour in Meckel's diverticulum
• ovarian carcinoid
• cardiac valve lesions from carcinoid

und weiter:

• rectal cancer
• osteoblastische Knochenmetastasen
• Neurofibromatose Typ 1
• MIBG
• Ileitis terminalis
• spiculated periosteal reaction
• mesenteriale Pannikulitis
• hyperdenser Lymphknoten
• duodenal filling defects
• hypervaskularisierte Leberläsionen
• solitärer pulmonaler Rundherd
• multiple endokrine Neoplasie Typ 1
• Dünndarmtumoren
• ultrasound appearances of liver metastases
• carcinoid cardiac lesions
• duodenal carcinoid tumor
• ovarian carcinoid tumours
• bronchial adenoma
• Knochenmetastasen bei Karzinoid
• carcinoid tumours of the lung
• carcinoid tumour of the appendix
• metastatic carcinoid tumor
• lung mass with calcification
• pulmonary carcinoid tumours
• primary hepatic carcinoid
• fat ring sign
• primary renal carcinoid tumor
• peripheral pulmonary carcinoid tumour
• carcinoid of the terminal ileum
• fat halo sign of mesenteric panniculitis
• thymic carcinoid tumour
• lower abdominal / pelvic calcification
• endobronchial carcinoid tumor
• sclerosing mesentritis
• Cup Syndrom