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)

Sixteen patients with metastatic carcinoid tumor and the malignant carcinoid syndrome were treated with combined cyclophosphamide and methotrexate therapy in a regimen previously described as highly effective. Toxicity was relatively mild and consisted primarily of leukopenia. One patient experienced some symptomatic benefit and minor reduction in hepatomegaly and 5-hydroxyindoleacetic acid excretion. None met our criteria for an objective response. Combined cyclophosphamide and methotrexate therapy does not appear to offer significant benefit for this disease.
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PMID:Evaluation of combined cyclophosphamide and methotrexate therapy in the treatment of metastatic carcinoid tumor and the malignant carcinoid syndrome. 620 Dec 71

A 55-year-old woman with an ovarian carcinoid presented with intermittent facial and cervical flushing for 10 years, watery diarrhea for 4 years, and abdominal pain without hepatomegaly. Markedly elevated systemic venous and arterial serotonin levels (830 ng/ml; nl = 50-200 ng/ml) were found. The highest serotonin levels were observed in the superior vena caval system, but serotonin as a marker for tumor localization was inaccurate and led to an unproductive neck exploration. The histological pattern of this tumor contained purely insular elements. No hepatic or nodal metastases were identified and the lesion was unilateral. Substance P levels were elevated in the venous drainage of the left ovary and in retrospect correctly localized the ovarian tumor. This peptide may prove to be another carcinoid tumor marker in addition to serotonin and 5-hydroxyindoleacetic acid. Substance P may also be an important mediator of symptoms in patients with carcinoid syndrome.
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PMID:Substance P in the localization of a carcinoid tumor. 620 86

A patient with a primary carcinoid tumor of the orbit is described. No other tumor had been found during the 15-year interval since the onset of unilateral proptosis. Symptoms of the carcinoid syndrome were absent, and the urinary levels of 5-hydroxyindoleacetic acid were normal. Histologically, the bulky, noninfiltrating tumor compressed but did not invade the optic nerve. The argyrophilic cells were arranged in solid lobules and formed abundant, rosettelike structures. Pleomorphic neurosecretory granules were demonstrated by transmission electron microscopy.
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PMID:Primary carcinoid tumor of the orbit. A clinicopathologic study with histochemical and electron microscopic observations. 661 5

We are reporting on the first human carcinoid cells ever cultured in vitro. These cells, termed CGP, originated from a jejunal carcinoid tumor. Before tumor resection, the 29-year old male patient presented high levels of blood serotonin and histamine and also of urinary serotonin and 5-hydroxyindole-acetic acid; values returned to normal 9 days after resection. CGP cells exhibit a very slow multiplication rate; generation time is about 10 days. From the first subculture, the main cytological, ultrastructural, and biochemical features of CGP cultures remain unchanged. The cells show most of the enterochromaffin cell histomorphological characteristics; for example, cytoplasmic granulations, specific of argyrophilic cells, can be seen both by electron microscopy and by light microscopy (preceded by silver impregnation). The high amounts of serotonin and histamine found by highly specific radioenzymatic assay in the supernatant of CGP cultures indicate that, after 6 months (25 subcultures), CGP cells have retained the main metabolic characteristics of the original tumor, i.e., the ability to synthesize, store, and release both serotonin and histamine.
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PMID:Serotonin and histamine production by human carcinoid cells in culture. 706 24

A 56-year-old women with carcinoid tumor of the gastrointestinal tract, which was metastatic to the mesenteric lymph nodes, was seen four months after bowel resection with new neurologic findings. Results of an initial examination suggested infection with mycobacteria, or fungi, but the condition of the patient deteriorated, and she died after antituberculous and antifungal therapy was begun. She never suffered from carcinoid syndrome, and 5-hydroxyindoleacetic acid and 5-hydroxytryptamine were not detected in blood samples. A postmortem examination disclosed widespread metastases of carcinoid tumor, including invasion of the cerebral hemispheres. In this article, CNS metastasis of carcinoid tumors is discussed as well as the possibility that drug interactions may have contributed to some of the patient's neurologic findings.
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PMID:Carcinoid tumor of the gastrointestinal tract with metastases to the brain. 711 91

We report a case of carcinoid-like syndrome in a patient with metastatic renal cell carcinoma. Peripheral venous plasma levels of prostaglandin (PG) E and of a derivative of PGF2 alpha were raised during the attacks. The urinary excretion of 5-hydroxyindoleacetic acid was repeatedly normal. The flushing attacks were not prevented by therapy with antihistamines, phenothiazines, antiserotonin agents, or glucocorticoids. Treatment with aspirin completely prevented the attacks, and its withdrawal led invariably to their recurrence.
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PMID:A carcinoid-like syndrome caused by a prostaglandin-secreting renal cell carcinoma. 739 16

A case of general anaesthesia for removal of carcinoid metastases is presented. Evidence of serotonin hypersecretion was shown by raised levels of 5-hydroxyindoleacetic acid, hypertension and tachycardia. The rarity of osteoblastic carcinoid metastases is discussed.
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PMID:Anaesthesia for removal of carcinoid metastases. A case of serotonin-secreting secondary tumour in the lumbar spine. 743 18

Over a five-and-a-half-year period, there were 298 laboratory requests for urinary 5-hydroxyindoleacetic acid (5-HIAA). The clinical and laboratory associations of the 24 patients in which there were 43 urinary 5-HIAA 24-h collection results greater than the laboratory upper reference limit are detailed. Four were confirmed carcinoid tumours and two were phaeochromocytomas. Flushing was a prominent symptom in 46% and diarrhoea or altered bowel habit in 37%. Associated with the raised urinary 5-HIAA values were increased levels of 4-hydroxy-3-methoxymandelic acid and homovanillic acid in 14.3% and 21%, respectively, of those collections where the metabolites were requested. Diagnostic imaging was performed in 57%. While the specificity was 88%, 5-HIAA is relatively insensitive in the diagnosis of carcinoid tumours and a more widespread use of diagnostic imaging including isotope scanning with labelled metaiodo-benzylguanidine, vasoactive intestinal peptide and octreotide is suggested.
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PMID:The clinical and laboratory correlates of an increased urinary 5-hydroxyindoleacetic acid. 747 66

We have performed 100 scintigraphic investigations using [111In-diethylenetriaminepentaacetic acid-D-Phe1]octreotide (111In-octreotide) single photon emission tomography (SPECT) in patients with carcinoid tumors. One or several lesions could be detected in 77 cases, and true negative results were obtained in 11 cases. There were false-negative results in 12 cases compared with results from conventional radiological methods. The ratio between the SPECT signals from the area with the highest uptake and normal lung was used as a tumor:background ratio. An attenuation correction was made in all investigations. We found that lesions in untreated patients had lower tumor:background ratios compared with those in patients treated with somatostatin analogues (medians, 10 and 40, respectively; P < 0.001) or IFN (median, 23; P = 0.03). In untreated patients, there was a correlation between the tumor:background ratio and the levels of urinary 5-hydroxyindoleacetic acid (U-5HIAA) and p-chromogranin A. The data obtained in the present investigation indicate that somatostatin receptor expression might be influenced by the treatment; i.e., a higher tumor:background ratio is found in patients treated with either somatostatin analogues or IFN. Furthermore, it was found that somatostatin receptor expression correlates with the levels of U-5HIAA and p-chromogranin A in untreated patients, and that 111In-octreotide SPECT scintigraphy is more likely positive in patients with elevated U-5HIAA values. This indicates that somatostatin receptor expression and elevated U-5HIAA are more likely present in patients with highly differentiated tumors and, thus, could be of prognostic value.
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PMID:Somatostatin receptor scintigraphy in patients with carcinoid tumors: comparison between radioligand uptake and tumor markers. 749 49

We monitored long-term (median 11 months) concentrations of platelet serotonin and urinary serotonin, 5-hydroxyindoleacetic acid, and seven catecholamine metabolites in 44 patients with carcinoid tumors. Tumor serotonin and catecholamine contents (11 patients) and urinary histamine and N-methylhistamine (15 patients) were determined. Consistently increased concentrations of indoles, notably platelet serotonin, were observed in 96%, 43%, and 0% of patients with mid-, fore-, and hindgut carcinoids, respectively. Urinary dopamine metabolites, notably 3-methoxytyramine, were consistently increased in 38%, 20%, and 7% of patients with mid-, hind-, and foregut carcinoids, respectively. For urinary norepinephrine/epinephrine metabolites, notably normetanephrine and metanephrine, these data were 33%, 20%, and 14%, respectively. Midgut carcinoid tumors had the highest serotonin contents, whereas concentrations of catecholamines were independent of primary localization. There was no consistent relation between biogenic amine contents in tumors and urinary excretion of the amine metabolites. Occurrence of carcinoid syndrome was related to increased serotonin production rate. Increased histamine production is not an important feature in patients with lung carcinoids or liver-metastasized ileum carcinoids.
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PMID:Serotonin, catecholamines, histamine, and their metabolites in urine, platelets, and tumor tissue of patients with carcinoid tumors. 750 8


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