Tuesday, October 20, 2015

Study group discussion: Carcinoid syndrome

What's carcinoid syndrome?

It's caused by serotonin. There's a GI tumor called carcinoid tumor which secretes it. So basically, the syndrome is caused by serotonin (Flushing, wheezing, etc)

What's the treatment for carcinoid?

Somatostatin analog, octreotide.

Which vitamin deficiency is associated with carcinoid syndrome?

Niacin!

What's the most common childhood lung neoplasm?
Primary carcinoid of the lung.

Carcinoid of lung:
If suspected, biopsy? Yes.
Do they produce 5-HIAA? Yes.
Typical carcinoid syndrome? No.
Which valve affected in lung carcinoid? Mitral.
Resect nodes? Yes.
RT or chemo? No. (RT + Chemo resistant!)

Differential of carcinoid syndrome symptoms?
Glucagonoma
Gastirnoma
Thyrotoxicosis
Rosacea

Interesting case: Typical Acute Appendicitis - > Appendectomy - > Incidentally found a nodule intraoperatively.
What is your next step? What is your suspected diagnosis? What is treatment?

Suspected diagnosis is carcinoid, get a frozen section NOW, don't need consent for treatment!

Treatment is right hemicolectomy if:
Tumor size > 2cm
If tumor located at BASE of appendix If tumor infiltrates mesoappendix.

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