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'''For the patient information, click [[Carcinoid syndrome (patient information)|here]]'''
{{DiseaseDisorder infobox |
{{DiseaseDisorder infobox |
   Name          = Carcinoid |
   Name          = Carcinoid |
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   OMIM          = 114900 |
   OMIM          = 114900 |
   MedlinePlus    = 000347 |
   MedlinePlus    = 000347 |
   eMedicineSubj  = med |
   eMedicineSubj  = |
   eMedicineTopic = 271 |
   eMedicineTopic = |
   DiseasesDB    = 2040 |
   DiseasesDB    = 2040 |
   MeshID        = D002276 |
   MeshID        = D002276 |
}}
}}
{{Search infobox}}
{{Carcinoid syndrome}}
{{CMG}}
{{CMG}}


{{Editor Help}}
==[[Carcinoid syndrome overview|Overview]]==
==Overview==
'''Carcinoid''' (also '''carcinoid tumour''' or '''carcinoid tumor''') is slow-growing but often [[malignant]] type of [[neuroendocrine tumour]], originating in the cells of the [[neuroendocrine system]]. Carcinoid tumours are [[apudomas]] that arise from the [[enterochromaffin cell]]s throughout the gut. They are most commonly found in the [[foregut]] (35.6% cases) with [[lung]], [[bronchus]] and [[trachea]] constituting 27.9% cases from where they rarely [[metastasis]]e (except in case of pancreas). The next most common affected area is the small intestine especially the midgut (32.1% cases) with the highest proportion from [[ileum]] at 14.9% of all cases [as per the PAN-SEER data (1973-1999)]. In cases of metastases it can lead to [[carcinoid syndrome]]. This is due to the production of [[serotonin]], which is released into the systemic circulation, which leads to symptoms of cutaneous flushing, [[diarrhea]], [[bronchoconstriction]] and right-sided [[cardiac]] [[heart valve disease|valve disease]].


They were first characterized in 1907 by Siegfried Oberndorfer, a German [[pathologist]] at the University of Munich, who coined the term ''karzinoide'', or "carcinoma-like", to describe the unique feature of behaving like a [[benign tumour]] despite having a [[malignant]] appearance microscopically. The recognition of their endocrine-related properties were later described by Gosset and Masson in 1914, and these tumours are now known to arise from the enterochromaffin (EC) and enterochromaffin-like (ECL) cells of the gut.
==[[Carcinoid syndrome classification|Classification]]==


==Symptoms==
==[[Carcinoid syndrome historical perspective|Historical Perspective]]==
Most carcinoids are asymptomatic through the natural lifetime and are discovered only upon surgery for unrelated reasons; these are called ''coincidental carcinoids''. But all carcinoids are considered to have malignant potential.


About 10 percent of carcinoids secrete excessive levels of a range of [[hormone]]s, most notably [[serotonin]] (5-HT), causing:
==[[Carcinoid syndrome pathophysiology|Pathophysiology]]==
* [[Flushing (physiology)|Flushing]]
* [[Diarrhea]]
* [[Wheezing]]
* [[Abdominal cramps|Abdominal cramping]] 
* [[Peripheral edema]]


This constellation of symptoms is called ''[[carcinoid syndrome]]'' or (if acute) ''carcinoid crisis''. Occasionally, [[haemorrhage]] or the effects of tumour bulk are the presenting symptoms. The most common originating sites of carcinoid is the small bowel, particularly the ileum; carcinoid tumors are the most common malignancy of the appendix, and ovarian origin, though reported, is rare.
==[[Carcinoid syndrome epidemiology and demographics|Epidemiology & Demographics]]==


==Treatment==
==[[Carcinoid syndrome risk factors|Risk Factors]]==
[[Surgery]], if feasible, is the only curative therapy. If the tumour has metastasized (most commonly, to the [[liver]]), the tumour may be ineligible for surgery (unresectable), though there are many promising treatment modalities, such as radiolabeled [[octreotide]], that are very effective in arresting the growth of the tumours and prolonging survival in patients with liver metastases.
 
==[[Carcinoid syndrome screening|Screening]]==
 
==[[Carcinoid syndrome causes|Causes]]==


[[Chemotherapy]] is of little benefit and is generally not indicated. [[Octreotide]] (a [[somatostatin]] analogue) may decrease the secretory activity of the carcinoid.
==[[Carcinoid syndrome differential diagnosis|Differentiating Carcinoid syndrome from other Diseases]]==


Carcinoid tumours are the most common malignant tumour of the appendix, but they are most commonly associated with the small intestine, and they can also be found in the [[rectum]] and [[stomach]]. They are known to grow in the liver, but this finding is usually a manifestation of metastatic disease from a primary carcinoid occurring elsewhere in the body. They have a very slow growth rate compared to most malignant tumours. From Dr. Vinoth
==[[Carcinoid syndrome natural history|Natural History, Complications & Prognosis]]==


== Goblet Cell Carcinoid ==
==Diagnosis==
[[Carcinoid syndrome history and symptoms|History & Symptoms]] | [[Carcinoid syndrome physical examination|Physical Examination]] | [[Carcinoid syndrome staging|Staging]] | [[Carcinoid syndrome laboratory tests|Lab Tests]] | [[Carcinoid syndrome electrocardiogram|Electrocardiogram]] | [[Carcinoid syndrome chest x ray|Chest X Ray]] | [[Carcinoid syndrome CT|CT]] | [[Carcinoid syndrome MRI|MRI]] | [[Carcinoid syndrome echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Carcinoid syndrome other imaging findings|Other Imaging Findings]] | [[Carcinoid syndrome other diagnostic studies|Other Diagnostic Studies]]


This is considered to be a hybrid between an [[exocrine]] and [[endocrine]] tumour derived from crypt cells of the appendix. Histologically, it forms clusters of goblet cells containing mucin with a minor admixture of Paneth cells and endocrine cells. The growth pattern is distinctive: typically producing a concentric band of tumour nests interspersed among the [[muscle]] and [[stroma]] of the appendiceal wall extending up the shaft of the appendix. This makes the lesion difficult to suspect grossly and difficult to measure. Small tumour nests may be camouflaged amongst the muscle or in periappendiceal fat; [[cytokeratin]] preparations best demonstrate the tumour cells; [[mucin]] stains are also helpful in identifying them. They behave in a more aggressive manner than do classical appendiceal carcinoids. Spread is usually to regional lymph nodes, [[peritoneum]], and particularly the ovary. They do not produce sufficient hormonal substances to cause the carcinoid or other endocrine syndromes. In fact, they more closely resemble exocrine than endocrine tumors. The term 'crypt cell carcinoma' has been used for them, and though perhaps more accurate than considering them carcinoids, has not been a successful competitor. The ICD-O code for goblet cell carcinoid is 8243/3.
==Treatment==
[[Carcinoid syndrome medical therapy#Chemotherapy|Chemotherapy]] | [[Carcinoid syndrome surgery#Surgery|Surgery]] | [[Carcinoid syndrome primary prevention|Primary Prevention]] | [[Carcinoid syndrome secondary prevention|Secondary Prevention]]  


==See also==
==Related chapters==
* [[Carcinoid syndrome]]
* [[Carcinoid syndrome]]


==External links==
==Resources==
 
* [http://www.caringforcarcinoid.org Caring for Carcinoid Foundation]
* [http://www.caringforcarcinoid.org Caring for Carcinoid Foundation]
* http://www.netumoradvisor.org
* http://www.netumoradvisor.org
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* [http://www.carcinoid.org  The Carcinoid Cancer Foundation]
* [http://www.carcinoid.org  The Carcinoid Cancer Foundation]


[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Gastroenterology]]


{{SIB}}
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[[de:Karzinoid]]
[[de:Karzinoid]]
[[ja:カルチノイド]]
[[ja:カルチノイド]]

Revision as of 15:22, 19 January 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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