- Carcinoid tumors are rare, slow-growing tumors derived from enterochromaffin cells that make up the amine precursor system
- They are most commonly located in the GI tract and the bronchopulmonary systems. Incidence ranges from 3-4 per 100,000 per year.
- At the time of diagnosis, 30% of patients have disseminated disease and malignant carcinoid syndrome. This syndrome includes cutaneous flushing, GI hypermotility, heart involvement, and bronchospasm.
- Carcinoid crisis (flushing, hypotension, and bronchospasm) can be precipitated by catecholamines and histamine-releasing drugs
- Avoid morphine, meperidine, histamine-releasing neuromuscular blockers, catecholamines, thiopental, atracurium, succinylcholine
- Etomidate, rocuronium, fentanyl are safe to use
- Carcinoid syndrome includes hepatic metastases, cutaneous flushing, diarrhea, bronchospasm, and structural heart disease
- Serotonin, an active hormone, causes endocardial fibrous plaque deposits
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