Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007095 (carcinoid)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 112 000 patients undergoing surgery between 1952 and 1973, 67 had a primary tumor of the small intestine. 22 patients had a benign tumor, 8 a carcinoid, 21 carcinoma and 15 sarcoma. Benign tumors were more frequent in the duodenum and ileum, carcinoids in the terminal ileum and carcinomas in the duodenum and jejunum. Sarcomas were found equally in all parts of the small intestine. The most common symptom for all types of the tumor was variable pain in the abdomen. Loss of weight occurred only in patients with carcinomas and sarcomas; heavy intestinal blood loss was most common in patients with benign tumors. Benign tumors often show invagination, while sarcomas cause occlusive ileus or perforation. All duodenal tumors show heavy intestinal bleeding but hematemesis is rare. Emergency surgery was necessary in 42% of patients with benign tumors or sarcoma and in 30% of patients with carcinoma. Five-year survival in patients with benign tumors is excellent (100%). Compared to this, five-year survival in patients with carcinoma, sarcoma or carcinoids is only 15%.
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PMID:[Complications in primary tumors of the small intestine]. 16 32

Casuistically is reported on two patients with an endocrine inactive ileum carcinoid, in whom the anamnesis with 5 weeks or 10 months was very short and atypical. Continuously increasing abdominal pain and gradual formation of a lower ileus of the small intestine or profuse watery diarrhoeas were the leading symptoms. Intraoperatively or autoptically in each case a very small (less than 1.5 cm) ileum carcinoid was found, which had led to a stenosing of high degree, there were no fibroses of the endocardium, no liver metastases--accordingly the secretion of serotonine metabolites (5-HIES) in the urine had been normal. The possibility of a so-called endocrine-nervous enteropathy in the female patient with the diarrhoea symptomatology and the necessity of a rapid diagnostic clarification in suspicion of a tumour in the lower small intestine are discussed, since such a suspicion in most cases corresponds to a carcinoid and thus there exists a great chance of cure.
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PMID:[Clinical aspects of the endocrinologically inactive small intestinal carcinoid]. 70 3

A case of the carcinoid tumour of ileum causing hormone producing multiple hepatic metastases was described. Sometimes after feeding and drinking of beer the "flush" and the diarrhoea appeared. Multiple hepatic metastases were established by ultrasound. Two and a half years ago the patient already was examined and treated by another hospital. In this time the origin of the primaer carcinoid tumour was not found and the superselective embolisation of the right lobe of the liver was made which caused a carcinoid crisis. Later the complaints were renewed and once more the patient was examined. The origin of the illness was proved in the lower ileum by CT (computer tomography), angiography and I131 MIBG (metajod-benzyl-guanidin) scintigraphy. Another embolisation of the liver caused a newer carcinoid crisis. The operation of primaer carcinoid tumour was decided because of the danger of carcinoid crisis and ileus. In the perioperative period the patient was protected against carcinoid crisis by Sandostatin (made in SANDOZ, Basel), because the preoperative therapy, the anaesthetics and the surgical manipulation could have caused a carcinoid crisis. In Hungary the authors used for the first time somatostatin in perioperative period to protect the patient against carcinoid crisis.
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PMID:[Prevention of carcinoid tumor crisis]. 134 72

In a prospective study of 103 patients with carcinoid tumors consecutively referred for medical treatment, the most common sites of the primary tumors were the ileum (73%), bronchi (7%), and jejunum (4%). All patients had local metastases, and 96 (93%) also had liver metastases. The most common initial symptoms were diarrhea (32%), ileus (25%), and flush (23%). The overall frequency of diarrhea was 84% and of flush was 75%. Heart insufficiency caused by cardiac valve disease was seen in 33% of the patients. The carcinoid syndrome, including flush, diarrhea, and elevated urinary 5-hydroxyindole acetic acid (5-HIAA) concentrations, was manifested by 69 patients (67%), 64 of whom (93%) had carcinoid tumors of mid-gut origin. Elevated urinary 5-HIAA was found in 91 patients (88%), of which 89 displayed liver metastases. The plasma concentration of the tachykinin neuropeptide K (NPK) was elevated in 67 patients (66%), 63 of whom had tumors of the mid-gut region. Serum pancreatic polypeptide (PP) and human chorionic gonadotrophin alpha levels were elevated in 43% and 28% of the patients, respectively, and the highest levels were found in patients with metastatic bronchial carcinoid tumors. Thirty-nine of the 103 patients are now dead; 18 died of tumor progression, whereas 14 patients died of heart failure secondary to a carcinoid tricuspidal valve insufficiency. The estimated median survival from the time of histologic diagnosis was 14 years, and from the time of carcinoid syndrome was 8 years.
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PMID:Malignant carcinoid tumors. An analysis of 103 patients with regard to tumor localization, hormone production, and survival. 244 Mar 90

Use of the biofragmentable anastomosis ring (BAR) was attempted in 33 patients at two New York City institutions and employed in 31 instances. Anastomoses performed were end-to-end enterocolic (n = 15), colocolic (n = 15), and side-to-side colocolic (n = 1). Patients ranged in age from 27 to 86 years, with the following diagnoses: primary colon cancer, 15; sessile adenoma, four; colostomy, five; diverticulosis, two; metastatic cancer with obstruction, multiple polyposis, perforated appendiceal mass, malignant carcinoid of appendix, intussuscepting right colon mass, one each. In two instances use of the device was aborted because of concern with the blood supply to the bowel wall in one and tissue edema in another. The average duration of postoperative ileus was 4.7 days. Two patients were subsequently treated for small bowel obstruction thought unrelated to use of the anastomotic device. There were no deaths and no evidence of stricture.
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PMID:Murphy's Button revisited. Clinical experience with the biofragmentable anastomotic ring. 842 5

Carcinoid tumors are new growths from neuroendocrine cells. The following clinical variants of carcinoid were observed in 11 patients with histologically verified carcinoid: 1) asymptomatic variant (an occasional finding at endoscopy)--2 cases; 2) carcinoid with symptoms of a mass detected at surgery--2 cases of intestinal ileus, 2 cases of appendix carcinoid simulating acute appendicitis; 3) carcinoid with hepatic metastases and carcinoid syndrome with unknown primary focus--2 cases; 4) carcinoid with metastases to the liver and carcinoid syndrome with location of the primary tumor in the lungs (2 cases) and pancreas (1 case). It is stated that carcinoid tumors are encountered more frequently than diagnosed (0.1-0.5% of all the tumors). Manifestations of carcinoid syndrome allow to diagnose carcinoid only at late stage when a large mass of hormone-active tumor tissue and metastases to the liver are present.
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PMID:[Carcinoid tumors]. 1006 96

More than 70% of all carcinoids are localized in the gastrointestinal tract. Carcinoids of the upper, middle and lower intestines have to be distinguished ontogenetically. The classification according to Capella takes into account the size of the tumor (< 0.9 cm; 1-2 cm; > 2 cm), the grade of invasion of other structures, the grade of angioinvasion, the biologic behaviour, the grade of differentiation and the hormonal activity of the tumor. A carcinoid-syndrome is rarely found. Carcinoids of the small intestine occur multiple in 30-50% and in 20-30% a second malignant tumor is seen. In carcinoids of the colon this percentage is even higher (25-40%). The therapy of carcinoids depends on the size of the tumor and consecutively on the risk of metastasis. A local excision or non-oncologic radical operative procedure is justified in carcinoids smaller than 1 cm. In tumors 1-2 cm in size an individual decision has to be made. Larger tumors should be operated according to oncologic standards. Palliative resections, even of the liver, may be indicated to relieve the symptoms of a carcinoid-syndrome or, to prevent ileus or bleeding in the gastrointestinal tract. The prognosis of gastrointestinal carcinoids is heterogenous: The five-year-survival-rate of appendix-carcinoids is 85.9% over all stages. In rectal carcinoids this rate amounts to 72.2%, in carcinoids of the small intestines to 55.4% and in colon-carcinoids to 41.6%. Carcinoids of the stomach have a five-year-survival-rate of 64.3% in the absence of metastases. Within carcinoids of the stomach type III-tumors have the worst prognosis with a median survival time of 6.5 months.
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PMID:[Surgical therapy of carcinoid tumors of the gastrointestinal tract]. 1169 82

A complex of clinical, functional, and morphological studies was made in 20 patients aged 39 to 78 years who had histologically verified gastrointestinal carcinoids in the pre- and postoperative periods, by employing laboratory tests and instrumental techniques. Removed tumors were morphologically studied. Sixteen patients were operated on. Among them, 10 and 6 patients underwent planned and emergency operations, respectively. On referral for emergency laparotomy, the preoperative diagnoses were acute ileus in 2 cases, acute pancreatitis in 1, and acute appendicitis in 3. The local paracrine effect of serotonin on the intestinal wall leads to spasm and fibrosis, which manifests itself as the clinical picture of obstruction of a hollow organ or acute appendicitis. Cordlike or concentrated deformity as a kink is a characteristic sign of small intestinal carcinoid. Formation of fibrosis occurs not only in the pathways of evacuation of excess serotonin from hepatic metastases into the right ventricle of the heart (Hedinger's syndrome), but by the paracrine pathway in the immediate vicinity of a carcinoid tumor, in whatever organ the tumor is located.
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PMID:[Manifestations of local fibrosis in the clinical picture of carcinoids of digestive organs]. 1466 72

Carcinoid tumors are slowly growing malignant neoplasms associated with an indolent clinical course. About 60% of such tumors are located within the gastrointestinal tract. We describe an unusual case of small bowel obstruction associated with a carcinoid tumor of the ileum. A 70-year-old woman was presented with abdominal pain, vomiting, and clinical signs of mechanical bowel obstruction. X-ray and CT-scan of the abdomen showed hydroaeric levels and the presence of intraluminal hyperdense "stones", presumably of gallbladder origin. A diagnostic laparotomy revealed that a large part of the terminal ileus was edematous, with prominent evidence of intestinal loop adhesions. The edematous part of the ileum was resected. Incision of the intestinal wall revealed a 2-cm soft mass at 8 cm from the ileocecal valve, where the presence of ten fruit pits obstructed the intestinal cavity. Histopathological examination confirmed the diagnosis of a carcinoid tumor. An interesting case of small-bowel obstruction with a double cause is presented: an ileal carcinoid and fruit pit bezoars. The pathophysiology of the obstruction is discussed.
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PMID:Phytobezoars as a cause of small bowel obstruction associated with a carcinoid tumor of the ileocecal area. 1499 80

A 75-year-old woman had an operation for gallstone ileus without cholecystectomy in other hospital and she was admitted to our hospital because of duodenal adenoma with severe atypia and small carcinoid in proximal duodenal wall. Distal gastrectomy and cholecystectomy were performed. Histological studies revealed the existence of cholecystoduodenal fistula and suggested the existence of gallbladder carcinoma progressed to the duodenal wall through the fistula. Cystic duct dissection and lymph nodes dissection were performed. It has been theorized that a cholecystoduodenal fistula may represent a significant risk factor in the development of gallbladder carcinoma because of the chronic reflux of duodenal contents which includes pancreatic juice. Our case may support this theory. In this case, we thought that the formation of gallbladder cancer could have been avoided if the cholecystectomy was performed in the first operation for gallstone ileus. It is very important that cholecystectomy should be performed when an existence of cholecystoduodenal fistula is highly suspected.
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PMID:[Gallbladder carcinoma, progressed along cholecystoduodenal fistula--a case report]. 2122 90


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