Karsinoidler ve karsinoid sendrom
South Med J. 2009 Oct;102(10):1032-40. doi: 10.1097/SMJ.0b013e3181b67356.
Carcinoid tumors of the gastrointestinal tract.
Ghevariya V, Malieckal A, Ghevariya N, Mazumder M, Anand S.
Division of Gastroenterology, The Brooklyn Hospital Center, Brooklyn, NY, USA.
The gastrointestinal tract is the largest neuroendocrine system in the body.
Carcinoid tumors are amine precursor uptake decarboxylase (APUD) omas that arise
from enterochromaffin cells throughout the gut. These tumors secrete discrete
bioactive substances producing characteristic immunohistochemical patterns. Most
tumors are asymptomatic and detected at late stages. Hepatic metastases are
commonly responsible for carcinoid syndrome. The small bowel is the most common
location of carcinoids. Computed tomography scan and magnetic resonance imaging
are useful in the detection of these tumors. The measurement of bioactive amines
is the initial diagnostic test. Various treatment options, including somatostatin
analogs, interferon, chemotherapy, surgery, hepatic artery chemoembolization, and
surgery have emerged in the past two decades. However, the incidence and
prevalence of carcinoid tumors has increased, while mean survival time has not
changed significantly. The lack of standardized classification, federal support,
and an incomplete understanding of the complications of this disease are some of
the impediments to progress in treatment.
Oncologist. 2008 Dec;13(12):1255-69. doi: 10.1634/theoncologist.2008-0207. Epub
2008 Dec 17.
Carcinoid tumors.
Pinchot SN, Holen K, Sippel RS, Chen H.
Section of Endocrine Surgery, Department of Surgery, University of Wisconsin,
Madison, WI 53792, USA.
Carcinoid tumors are rare, slow-growing neuroendocrine tumors arising from the
enterochromaffin cells disseminated throughout the gastrointestinal and
bronchopulmonary systems. Though they have been traditionally classified based on
embryologic site of origin, morphologic pattern, and silver affinity, newer
classification systems have been developed to emphasize the considerable clinical
and histopathologic variability of carcinoid tumors found within each embryologic
site of origin. These neoplasms pose a diagnostic challenge because they are
often innocuous at the time of presentation, emphasizing the need for a
multidisciplinary diagnostic approach using biochemical analysis, standard
cross-sectional imaging, and newer advances in nuclear medicine. Similarly,
treatment of both primary and disseminated carcinoid disease reflects the need
for a multidisciplinary approach, with surgery remaining the only curative
modality. The prognosis for patients with these tumors is generally favorable;
however, it can be quite variable and is related to the location of the primary
tumor, extent of metastatic disease at initial presentation, and time of
diagnosis.
