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

Jump to navigation Jump to search
Line 18: Line 18:
*[[Obstruction|Bowel obstruction]]
*[[Obstruction|Bowel obstruction]]
*[[Gastrointestinal bleeding]]
*[[Gastrointestinal bleeding]]
*[[Heart failure|Right-sided heart failure]]
*Carcinoid heart disease develops in more than one-third of patients with carcinoid syndrome:<ref> General Information About Gastrointestinal (GI) Carcinoid Tumors
. National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 24, 2015</ref>
*Fibrosis of the tricuspid valve and pulmonary valve, rarely the mitral valve in cases with left sided involvement
*Fibrosis of the tricuspid valve and pulmonary valve, rarely the mitral valve in cases with left sided involvement
**"TIPS" - [[tricuspid insufficiency|Tricuspid Insufficiency]], [[pulmonary stenosis|Pulmonic Stenosis]] (fibrosis of tricuspid and pulmonary valves)
:*Tricuspid and pulmonic regurgitation
:*Pulmonary stenosis
:*Mitral and aortic insufficiency
:*Cardiac dysrhythmias
**"TIPS" - [[tricuspid insufficiency|Tricuspid Insufficiency]], [[pulmonary stenosis|Pulmonic Stenosis]]


==Prognosis==  
==Prognosis==  

Revision as of 00:28, 4 October 2015

Carcinoid syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Carcinoid Syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Carcinoid syndrome natural history, complications and prognosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Carcinoid syndrome natural history, complications and prognosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Carcinoid syndrome natural history, complications and prognosis

CDC on Carcinoid syndrome natural history, complications and prognosis

Carcinoid syndrome natural history, complications and prognosis in the news

Blogs on Carcinoid syndrome natural history, complications and prognosis

Directions to Hospitals Treating Carcinoid syndrome

Risk calculators and risk factors for Carcinoid syndrome natural history, complications and prognosis

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, and 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):[2]
    • 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:[3]

  • Increased risk of falls and injury (from hypotension)
  • Bowel obstruction
  • Gastrointestinal bleeding
  • Carcinoid heart disease develops in more than one-third of patients with carcinoid syndrome:[4]
  • Fibrosis of the tricuspid valve and pulmonary valve, rarely the mitral valve in cases with left sided involvement
  • Tricuspid and pulmonic regurgitation
  • Pulmonary stenosis
  • Mitral and aortic insufficiency
  • Cardiac dysrhythmias

Prognosis

  • Prognosis of carcinoid tumor is generally good and the 5-year survival rate of patients is approximately:[1]
  • Stomach-75.1%
  • Small Intestine-76.1%
  • Appendix-76.3%
  • Rectum-87.5%
  • Factors that determine the prognosis of patients with gastrointestinal carcinoid tumors include:[5]
  • 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. General Information About Gastrointestinal (GI) Carcinoid Tumors . National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 24, 2015
  3. Carcinoid syndrome. U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000347.htm
  4. General Information About Gastrointestinal (GI) Carcinoid Tumors . National Cancer Institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#link/_49_toc Accessed on September 24, 2015
  5. Carcinoid tumor. National cancer institute. http://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq


Template:WikiDoc Sources