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:

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

und weiter:

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