Carcinoid Syndrome

Exam Cram

• Presentation:  FLUSHING = Carcinoid in MCQs; other symptoms include GI nausea

• Investigations: 5HIAA elevation (serotonin breakdown product)

• Management:

  • • 1. Somatostatin analogues (e.g. octreotide)

      2. Telotristat (diarrhoea)

Outline

Background

Carcinoid syndrome is characterised by ectopic serotonin production

Assessment

History

• > 65yrs, 6m of:

• FLUSHING

• Diarrhoea, palpitations, weight loss, reduced exercise tolerance

Examination

• Mild tenderness RUQ

• Hepatomegaly

Investigations

• 5-HAA: raised

• Liver ultrasound: metastasis

Diagnosis & Classification

Diagnostic criteria: raised 5-HAA + clinical symptoms

Classification

Management

Acute

• Somatostatin analogue: octreotide

Chronic

Surgical Reg Notes

Tryptophan hydroxylase: enzyme that catalyses the first step in serotonin production. 

Written in 2024