Carcinoid tumors of the gastrointestinal tract

South Med J. 2009 Oct;102(10):1032-40. doi: 10.1097/SMJ.0b013e3181b67356.

Abstract

The gastrointestinal tract is the largest neuroendocrine system in the body. Carcinoid tumors are amine precursor uptake decarboxylase (APUD) omas that arise from enterochromaffin cells throughout the gut. These tumors secrete discrete bioactive substances producing characteristic immunohistochemical patterns. Most tumors are asymptomatic and detected at late stages. Hepatic metastases are commonly responsible for carcinoid syndrome. The small bowel is the most common location of carcinoids. Computed tomography scan and magnetic resonance imaging are useful in the detection of these tumors. The measurement of bioactive amines is the initial diagnostic test. Various treatment options, including somatostatin analogs, interferon, chemotherapy, surgery, hepatic artery chemoembolization, and surgery have emerged in the past two decades. However, the incidence and prevalence of carcinoid tumors has increased, while mean survival time has not changed significantly. The lack of standardized classification, federal support, and an incomplete understanding of the complications of this disease are some of the impediments to progress in treatment.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Carcinoid Tumor / diagnosis*
  • Carcinoid Tumor / epidemiology
  • Carcinoid Tumor / therapy*
  • Chemoembolization, Therapeutic
  • Chromogranins / analysis
  • Diagnostic Imaging
  • Endoscopy, Gastrointestinal
  • Gastrointestinal Neoplasms / diagnosis*
  • Gastrointestinal Neoplasms / epidemiology
  • Gastrointestinal Neoplasms / therapy*
  • Humans
  • Hydroxyindoleacetic Acid / urine
  • Incidence
  • Interferons / therapeutic use
  • Liver Neoplasms / secondary
  • Liver Transplantation
  • Lymph Node Excision
  • Malignant Carcinoid Syndrome / etiology*
  • Protein Kinase Inhibitors / therapeutic use
  • Risk Factors
  • Serotonin / blood

Substances

  • Antineoplastic Agents
  • Chromogranins
  • Protein Kinase Inhibitors
  • Serotonin
  • Hydroxyindoleacetic Acid
  • Interferons