单词 | carcinoid syndrome |
释义 | carcinoid syndromecarcinoid syndrome[′kärs·ən‚ȯid ′sin‚drōm]carcinoid syndromecarcinoid[kahr´sĭ-noid]The specific symptoms associated with this disorder depend upon the site of the primary tumor; tumors are found most commonly in the appendix and the terminal third of the ileum but can also be in the bronchi, ovaries, testes, and anywhere along the entire length of the alimentary tract. The full set of carcinoid symptoms are manifested only when the liver is involved. Diagnosis of the condition is established by a 24-hour urine test for 5-hydroxyindoleacetic acid (5-HIAA), the end product of the breakdown of tryptophan to serotonin. Patients with carcinoid syndrome may have very high levels of 5-HIAA, 100 to 500 mg in 24 hours. Carcinoid tumors are not always benign and should be approached as if they were malignant growths. Surgical excision of the tumor and any associated mesenteric nodes is the treatment of choice. Chemotherapy can be used with metastatic disease, and other drugs are prescribed as indicated to manage the hypotension, diarrhea, flushing, and other symptoms. Efforts are made to improve nutrition and to avoid serotonin-containing foods, such as walnuts and bananas, which are known to precipitate an attack and make accurate diagnosis difficult. car·ci·noid syn·dromecarcinoid syndromeOncology A symptom complex caused by carcinoids, which arise from the enterochromaffin system, a system most concentrated in the midgut; carcinoids release vasoactive substances–eg, serotonin, and its metabolite, 5-HIAA, as well as bradykinin, histamine, PG, substance P; serotonin's precursor is tryptophan, used by the body to produce niacin and some proteins; carcinoid Sx are most common in metastases, often from a primary ileal carcinoid metastatic to the liver Clinical Episodic skin flushing on the face, spreading to the trunk, then telangiectasia, precipitated by alcohol, food, stress, or liver palpation; also diarrhea or GI obstructive symptoms, bronchospasm, wheezing, pleural, peritoneal, retroperitoneal, endocardial fibrosis of the right valves and right ventricular wall, which may cause failure, carcinoid myopathy and atrophy of type II muscle fibers Lab ↑ Serotonin, 5-HIAA in serum, urine Management Resection. See APUD system, Atypical carcinoid.car·ci·noid syn·drome(kahr'si-noyd sin'drōm)carcinoid syndromeA rare condition in which bowel tumours of cells of endocrine origin spread to other parts of the body and secrete large quantities of highly active substances such as SEROTONIN, HISTAMINE, BRADYKININ, ACTH, INSULIN or growth hormone. These cause symptoms such as flushing, diarrhoea, cramping abdominal pain, serious heart damage, arthritis and asthma. Carcinoid syndrome produces unpredictable and severe swings of blood pressure during general anaesthesia calling for careful anaesthetic management. The SOMATOSTATIN analogue drug octreotide (Sandostatin) is important in this context.Carcinoid syndromePatient discussion about carcinoid syndromeQ. what is carcinoid tumors? I had my appendix removed and the doctor came in the room very shocked and said it was full of carcinoid tumors. Im scared to get them somewhere else. |
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