Carcinoid Syndrome

Excerpt

Carcinoid syndrome is a clinical condition caused by metastatic, well-differentiated neuroendocrine tumors, most commonly arising from the midgut with liver metastases, and is characterized by the secretion of biogenic amines, particularly serotonin, leading to symptoms, eg, flushing, diarrhea, bronchospasm, and systemic complications, like carcinoid heart disease. Diagnosis is primarily achieved through measuring urinary 5-hydroxyindoleacetic acid (5-HIAA), supported by imaging for tumor localization and staging. Management depends on the primary tumor's type, location, and extent, including somatostatin analogs (eg, octreotide, lanreotide) to control hormone secretion, peptide receptor radioligand therapy (PRRT), and surgical or liver-directed interventions to reduce tumor burden. An interprofessional approach is essential to optimize outcomes, manage complications like carcinoid heart disease, and improve the quality of life for affected patients.