Carcinoid: symptoms

The main clinical and laboratory manifestations of carcinoid:

• attacks of blood tides in the face, neck, and chest - with the face, neck, neck, and upper body suddenly blushing. In these places the patient feels a burning sensation, a feeling of heat, numbness. Many patients at high tide have reddening of the eyes (conjunctiva injection), increased tearing, hypersalivation, edema of the face, tachycardia appears; a significant reduction in blood pressure is possible. At the beginning of the disease, the flush is rare (1-2 times in 1-2 weeks or even in 1-3 months), later they become daily and can disturb patients 10-20 times a day. The duration of the tides ranges from one to 5-10 minutes. Tides can appear quite suddenly, for no apparent reason, but they are often provoked by physical or emotional overexertion, drinking alcohol, fatty meat, cheddar cheese, medicines reserpine, histamine (they increase the release of serotonin). Tides are much more pronounced and are more frequent when the tumor is metastasized to the liver (in this case, degradation of serotonin in the liver is disturbed);
• Diarrhea is a characteristic sign of carcinoid syndrome; it is due to a significant increase in motility of the small intestine under the influence of serotonin. Diarrhea can be very pronounced, with a large amount of water (water diarrhea), protein, electrolytes (sodium, potassium, calcium) excreted in the feces; may develop hypoproteinemia, hypovolemia (with a decrease in blood pressure), hyponatomy, hypochloremia, hypokalemia, hypocalcemia;
• bronchospasm - observed in many patients, manifested by an attack of expiratory dyspnea, dry wheezing and buzzing wheezing with auscultation of the lungs;
• endocardial fibrosis - develops in 50% of patients; mainly affected the right heart, which leads to the development of insufficiency tricuspid valve and circulatory failure in the right ventricular type. Some patients develop pulmonary artery stenosis;

Carcinoid tumor, as potentially malignant, can metastasize to various organs, including the liver. The Leningrad scientists AA Nikonov and DB Tsikin (1977) described 8 cases of carcinoid of various parts of the digestive tract with metastases to the liver. In one case, signs of a carcinoid syndrome were absent, but the sudden jaundice, hepatomegaly and a significant increase in serum transaminase activity suggested a diagnosis of acute viral hepatitis. However, with puncture liver biopsy and subsequent histological examination of the biopsy specimens, tumor cells were detected, which then, in a special study, could be identified as carcinoid. The operation revealed a carcinoid tumor of the duodenum. In another case they described the symptoms of the disease for several years were regarded as a manifestation of chronic cholecystitis, but then rapid progression - significant weight loss, an increase in the liver with tuberosity of its surface made it possible to suspect a tumor disease. He was a carcinoid of the stomach with multiple metastases to the liver.

[1], [2], [3], [4]