CARCINOID TUMORS

SYMPTOMS

The symptoms of carcinoid tumors can vary depending on their location, size, and whether they produce hormones (functional tumors) or not (non-functional tumors). Common symptoms may include:

• Abdominal pain or discomfort.
• Flushing of the skin, particularly of the face and neck.
• Diarrhea or constipation.
• Wheezing or difficulty breathing (in cases of lung carcinoid tumors).
• Persistent cough or coughing up blood.
• Unexplained weight loss.
• Heart palpitations or rapid heartbeat.
• Changes in bowel habits or rectal bleeding.

DIAGNOSIS

Diagnosing carcinoid tumors typically involves a combination of imaging studies, laboratory tests, and histological examination of tumor tissue. Key diagnostic steps may include:

• Imaging tests: CT scans, MRI scans, or octreotide scans may be used to visualize the location, size, and extent of the tumor.
• Blood tests: Measurement of biomarkers such as chromogranin A (CgA) and serotonin levels may help in the diagnosis and monitoring of carcinoid tumors, particularly those associated with carcinoid syndrome.
• Endoscopic procedures: Upper endoscopy, colonoscopy, or bronchoscopy may be performed to visualize and biopsy suspicious lesions in the GI tract or lungs.
• Histopathological examination: Tissue samples obtained from biopsies or surgical resections are examined under a microscope to confirm the diagnosis of carcinoid tumor and assess tumor grade and stage.

TREATMENT

The treatment of carcinoid tumors depends on factors such as tumor location, size, grade, stage, and overall health status. Treatment options may include:

• Surgery: Surgical resection of the tumor is often the primary treatment for localized carcinoid tumors, aiming to remove the tumor and surrounding tissue to achieve complete excision.
• Somatostatin analogs: Medications such as octreotide or lanreotide may be used to control symptoms and slow tumor growth in patients with metastatic or unresectable carcinoid tumors.
• Peptide receptor radionuclide therapy (PRRT): PRRT involves the administration of radioactive substances that target tumor cells expressing somatostatin receptors, delivering radiation directly to the tumor while minimizing damage to surrounding tissues.
• Chemotherapy: Systemic chemotherapy may be used to treat advanced or metastatic carcinoid tumors, although response rates vary, and the benefits may be limited.
• Targeted therapy: Molecularly targeted drugs, such as everolimus or sunitinib, may be prescribed for patients with advanced carcinoid tumors that express specific molecular targets, such as mTOR or VEGF receptors.