Carcinoid syndrome natural history, complications and prognosis: Difference between revisions

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Common complications of carcinoid tumor include:
Common complications of carcinoid tumor include:
*Increased risk of falls and injury (from [[hypotension]])
*Increased risk of falls and injury (from [[hypotension]])
*Obstruction|Bowel obstruction]]
*[[Obstruction|Bowel obstruction]]
*[[Gastrointestinal bleeding]]
*[[Gastrointestinal bleeding]]
*[[Heart failure|Right-sided heart failure]]
*[[Heart failure|Right-sided heart failure]]

Revision as of 14:57, 30 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

If left untreated, patients with carcinoid syndrome may progress to develop flushing, diarrhea, and carcinoid heart disease (valvular heart disease and cardiac dysrythmias). Common complications of carcinoid tumor include increased risk of falls and injury (from hypotension), bowel obstruction, gastrointestinal bleeding, right-sided heart failure, and fibrosis of the tricuspid valve and pulmonary valve, more rarely the mitral valve in cases with left sided involvement. Prognosis is generally good, and the 5-year survival rate of patients with carcinoid syndrome is approximately 69.7%.[1]

Natural History

  • If left untreated, patients with carcinoid syndrome may progress to develop flushing, diarrhea, and carcinoid heart disease (valvular heart disease and cardiac dysrythmias):
    • Pathologically, the cardiac valves become thickened because of fibrosis
    • Tricuspid and pulmonic valves are affected to a greater extent than the mitral and aortic valves
  • They have a very slow growth rate compared to most malignant tumors

Complications

Common complications of carcinoid tumor include:

Prognosis

Prognosis is generally good, and the 5-year survival rate of patients with carcinoid syndrome is approximately 69.7%.[1]

  • Factors that determine the prognosis of patients with gastrointestinal carcinoid tumors include:[2]
  • Site of origin
  • Size of the primary tumor
  • Anatomical extent of disease
  • Negative prognostic factors include:
    • Carcinoid heart disease
    • High concentrations of the tumor markers - urinary 5-HIAA and plasma chromogranin A
    • Metastasis to the liver
    • Carcinoid tumor in the thymus
    • Overexpression of the proliferation antigen Ki-67
    • Mutation in the p53 gene

References

  1. 1.0 1.1 Maggard MA, O'Connell JB, Ko CY (2004). "Updated population-based review of carcinoid tumors". Ann Surg. 240 (1): 117–22. PMC 1356383. PMID 15213627.
  2. "Prognostic Factors".


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