UI - 12063867
AU - Toth M; Pronai L; Nemeth AM; Tulassay Z
SO - Orv Hetil 2002 May 12;143(19 Suppl):1087-92
Carcinoids are characteristically indolent, but heterogeneous tumors
with respect to their site of origin, endocrine features, clinical
manifestations and biologic behaviour. The authors summarize the current
laboratory, endoscopic and radiologic methods used for the diagnosis of
carcinoid tumors. Treatment modalities should be directed against the
tumor and the hormonal excess state. The authors review the outcome of
most frequently used therapies, including somatostatin-analogue and
interferon treatment, chemotherapy, embolization, receptor-targeted
radiotherapy and surgical intervention). Patients with carcinoid tumors,
with or without carcinoid syndrome, are best managed by a
UI - 12015856
AU - Altstadt TJ; Azzarelli B; Bevering C; Edmondson J; Nelson PB
Acromegaly caused by a growth hormone-releasing hormone-secreting
carcinoid tumor: case report.
SO - Neurosurgery 2002 Jun;50(6):1356-9; discussion 1360
AD - Department of Surgery, Section of Neurological Surgery, Indiana
University School of Medicine, Indianapolis, Indiana 46202-5124, USA,
OBJECTIVE AND IMPORTANCE: We describe a patient with acromegaly and
pituitary hyperplasia secondary to a growth hormone-releasing
hormone-secreting gastrointestinal carcinoid tumor. This case report
illustrates the importance of including this rare clinical syndrome in
the differential diagnosis of acromegaly for patients with suspected or
known neuroendocrine tumors. CLINICAL PRESENTATION: A 19-year-old,
Asian-American, male patient with a 2-year history of a nonresectable,
metastatic, intestinal carcinoid tumor presented with complaints of
headaches, arthralgias, sweats, and changing features. The examination
revealed a young subject with acromegalic features, without visual field
deficits. Magnetic resonance imaging revealed a diffuse sellar mass that
extended suprasellarly to compress the optic chiasm. Endocrinological
studies demonstrated a growth hormone level of more than 100 ng/ml and
an inappropriately elevated growth hormone-releasing hormone level.
INTERVENTION: The patient underwent transsphenoidal resection of the
pituitary mass for diagnostic and decompressive purposes. The
pathological examination revealed pituitary hyperplasia, without
evidence of an adenoma. Therapy with long-acting repeatable octreotide
(Sandostatin LAR; Novartis AG, Basel, Switzerland) was initiated
postoperatively, to further control the acromegaly and carcinoid tumor.
The soft-tissue swelling resolved, and the patient remained free of
headaches, arthralgias, and sweats at the 6-month follow-up examination.
CONCLUSION: Ectopic acromegaly is a rare syndrome that must be
recognized by neurosurgeons because its treatment differs from that of
classic pituitary acromegaly. We describe a patient for whom this
syndrome was documented with magnetic resonance imaging,
endocrinological testing, and pathological examinations.
UI - 12027412
AU - de Vries H; Verschueren RC; Willemse PH; Kema IP; de Vries EG
Diagnostic, surgical and medical aspect of the midgut carcinoids.
SO - Cancer Treat Rev 2002 Feb;28(1):11-25
AD - Department of Surgery, University Hospital Groningen, The Netherlands.
This review covers the incidence, prognosis, diagnosis and treatment of
midgut carcinoids with emphasis on the surgical and peri-operative
aspects. Midgut carcinoids are rare neuro-endocrine tumours which become
manifest once they have metastasized to the liver. Treatment of
metastatic disease may include radical resection but is usually
palliative. The tumour grows relatively slow. Besides the biochemical
effects resulting in the carcinoid syndrome, patients may suffer from
mechanical mass effects of the tumour. Medical treatment can alleviate
the biochemical effects of the tumour, but has a limited effect on
tumour growth. The introduction of octreotide was a milestone in
palliation of these symptoms and has led to more aggressive treatment
protocols. Treatment aimed at cytoreduction of hepatic metastasis and
diminished secretion of bioactive amines may achieve good palliation.
Cytoreduction may be performed by means of surgery, hepatic arterial
ligation, (chemo)embolization, cryosurgery, radio-frequency ablation,
internal radiation or even liver transplantation. The role of these
options will be discussed in this review. Copyright 2002 Published by
Elsevier Science Ltd.
UI - 11824067
AU - Di Cataldo A; Greco S; Caldarella P; Lanteri R; Li Destri G; Licata A
Carcinoid of the ileocaecal valve: a case report.
SO - Chir Ital 2001 Nov-Dec;53(6):879-82
AD - Cattedra di Chirurgia dell'Apparato Digerente, Policlinico
Universitario, Universita degli Studi di Catania.
The authors present a case of carcinoid of the ileocaecal valve. The
patient complained for over one year of mild pain in the right lower
quadrant of the abdomen. Colonoscopy had shown hyperaemia on the colic
side of the ileocaecal valve which appeared substenotic and biopsy
revealed micronodules formed by chromogranin-A-positive neuroendocrine
cells. Roentgenography of the small bowel and barium enema revealed a
specular filling defect in the caecum and in the terminal ileum near the
ileocaecal valve. Right hemicolectomy was performed and the definitive
diagnosis was carcinoid of the ileocaecal valve. The tumour had spread
to all layers of the intestinal wall and 4/19 lymph nodes were
metastatic. The patient refused an oncological examination; however,
three years after surgery there are no signs of recurrence. Carcinoids
have been included in the APUD system and usually present endocrine
activity. The 5-year survival of patients with gastrointestinal
carcinoids is 80% when located in the appendix and rectum as against 50%
in the stomach, jejunum and colon, because the localisation in the
appendix and rectum is marked by clinical signs of appendicitis and
rectal bleeding, which suggest diagnostic examinations useful for an
early diagnosis. Radical operations according to the rules of
oncologically correct surgery are the treatment of choice, while
complementary treatments have yet to be codified.
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