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notescarcinoidtumors ( ** )

Carcinoid tumors

Carcinoid tumors:

  • 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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