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Carcinoid Tumour

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Information about Carcinoid Tumour
Health & Medicine

Published on February 22, 2014

Author: amomtan

Source: slideshare.net

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Carcinoid Tumours Dr. Ahmed Almumtin

Introduction The term “carcinoid” “Carcinoid syndrome” vs “carcinoid tumour”

Epidemiology Carcinoids are relatively rare tumors. incidence 4.7:100,000 median age 63 male : female is it really increasing?

Distribution

Pathology and grading Origin. Different behaviour. Grading vs differentiation. Two sub-Groups: Well differentiated Poorly differentiated

Embryonic classification Based on Embryonic origin Foregut - stomach Midgut - Small intestine, Appendix Hindgut - Colon, Rectum, Genitourinary, Ovarian .. Metastatic

WHO Classification Te xt - Well differentiated: • Low grade • Intermediate Grade - Poorly differentiated • High grade

Continue classification European Neuroendocrine Tumour Society (ENTS) vs American Joint Committee on Cancer (AJNCC) vs WHO.

Carcinoid syndrome

Carcinoid Syndrome Definition Pathophysiology - mediators Tryptophan Metabolism Histamine Killekrien Prostaglandins Tachykinins Clinical features

Clinical Features of carcinoid syndrome Cutaneous flushing Venous telangiectasia diarrhoea bronchospasm cardiac valvular lesions

So, patient presents as a result of the carcinoid syndrome or as a result of tumour growth or as incidental finding

Diagnosis Biochemical testing: Urinary 5-HIAA Urinary Serotonin serum chromogranin Serum serotonin Tumour localisation CT MRI Scintigraphy OctreoScan PET scan Endoscopy

Basic principles of evaluation and management of patients with carcinoid tumours Radiographic Staging and Localisation Pathologic assessment of tumour differentiation and/or grade Removal of Tumour Control of carcinoid symptoms

Treatment of Localised Carcinoids - Appendix - Small intestine - Rectum - Colon - Stomach

Appendix Size >2 cm < 2cm Appendectomy vs Rt hemicolectomy

Small intestine Usual location. Matastasis prognosis

Rectum Treatment < 1 cm mucosa or submucosa > 2 cm or beyond muscolaris propria Prognosis

Colon Aggressive 5 years survival prognosis

Stomach Types options Medical therapy?

Prognosis Stage and Site of origin Tumour differentiation

Post-treatment F/U Gastric, Small intestine, Colonic, appendiceal and Rectal 3 to 12 months.. more than one year Gastric <= 2 cm

Te xt Thank you

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