Tumours of the midgut (jejunum, ileum and ascending colon, including carcinoid syndrome)

Best Pract Res Clin Gastroenterol. 2005 Oct;19(5):705-15. doi: 10.1016/j.bpg.2005.05.007.

Abstract

(Neuro-)endocrine tumours of the gastrointestinal tract are also called 'carcinoids'. (Neuro-)endocrine midgut tumours can be categorized according to their clinical behaviour. Most tumours are non-functioning. Functioning tumours are responsible for the carcinoid syndrome. The carcinoid syndrome is almost uniquely associated with midgut carcinoids. Symptoms of the carcinoid syndrome are caused by an excess of biogenic amines, peptides and other factors in the circulation. The typical symptoms of the carcinoid syndrome are diarrhoea, flushing, and carcinoid heart disease. Carcinoid heart disease involves the tricuspid and pulmonary valves and the endocardium. Serum chromogranin A and urinary excretion of 5-hydroxy-indoleacetic acid (5-HIAA) are biochemical markers. Carcinoid tumours express large numbers of high-affinity somatostatin receptors. These can bind the currently available octapeptide somatostatin analogues. In inoperable patients, biotherapy with somatostatin analogues and interferon-alpha is the treatment of choice. Somatostatin analogues and interferon-alpha significantly improve symptoms.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Carcinoid Tumor / epidemiology
  • Carcinoid Tumor / pathology*
  • Carcinoid Tumor / therapy*
  • Chemotherapy, Adjuvant
  • Colectomy / methods
  • Colon, Ascending / pathology
  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / therapy
  • Combined Modality Therapy
  • Female
  • Humans
  • Ileal Neoplasms / epidemiology
  • Ileal Neoplasms / pathology
  • Ileal Neoplasms / therapy
  • Intestinal Neoplasms / epidemiology
  • Intestinal Neoplasms / pathology*
  • Intestinal Neoplasms / therapy*
  • Jejunal Neoplasms / epidemiology
  • Jejunal Neoplasms / pathology
  • Jejunal Neoplasms / therapy
  • Male
  • Malignant Carcinoid Syndrome / epidemiology
  • Malignant Carcinoid Syndrome / pathology
  • Malignant Carcinoid Syndrome / therapy
  • Neoplasm Staging
  • Neuroendocrine Tumors / epidemiology
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / therapy
  • Prognosis
  • Radiotherapy, Adjuvant
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome