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At least 19 recordsLinked to original sources
PubMed1979

Combination chemotherapy trials in metastatic carcinoid tumor and the malignant carcinoid syndrome.

One hundred eighteen patients with metastatic carcinoid tumor were randomized to treatment with streptozotocin combined with cyclophosphamide or with 5-fluorouracil (5-FU). Commonly experienced side effects were nausea, vomiting, leukopenia, thrombocytopenia, and nephrotoxicity. Objective response rates among eligible and evaluable patients treated with the 5-FU combination was 14 of 42 (33%) and with the cyclophosphamide combination, 12 of 47 (26%). Among those patients with carcinoids primary to the small bowel the respective response rates were 44% and 37%. The overall response rates for patients with carcinoids of pulmonary or unknown origin were only 12% and 17%. There was no significant difference in patient survival between the two treatment arms. Among 11 patients who received crossover therapy with 5-FU alone there were two responders. There were no responders among eight patients treated with cyclophosphamide alone. Urinary 5HIAA excretion proved to be a useful biologic marker in these patients that correlated well with the observed measurements of tumor bulk. Median survival times from the diagnosis of unresectable malignant disease related to sites of origin of carcinoid tumor were the following: small bowel, 28.4 months; pancreas, 24.0 months; lung, 15.1 months; and unknown origin, 9.0 months. Metastatic carcinoid tumor is a malignant disease susceptible to chemotherapeutic approaches and continued investigation of the therapy of these neoplasms should be strongly encouraged.

Adolescent↗
PubMed1978

Multiple peripheral pulmonary carcinoids and tumorlets of carcinoid type, with restrictive and obstructive lung disease.

Multiple peripheral carcinoid tumors were found on lung biopsy in a 53 year old woman with an eight year history of pulmonary nodules. The biopsy specimen showed nodules varying from 1 to 7 mm in greatest diameter. The larger lesions were typical bronchial carcinoids whereas the smaller ones resembled pulmonary "tumorlets." Electron microscopy showed neurosecretory granules typical of carcinoids. The common multicentric origin of carcinoids and tumorlets from Kulchitsky cells is discussed. Pulmonary function testing revealed mild obstructive and restrictive defects, both attributed to the carcinoid tumors. The history, pathology and physiology of this unusual case are presented in detail, with a review of the literature. Obstructive airways disease, presumably due to the extensive bronchiolar involvement, has not previously been reported in this entity.

Airway Obstruction↗
PubMed1979

Urinary free cortisol excretion in patients with hyperserotoninaemia from the carcinoid syndrome.

To determine if patients with chronic hyperserotoninaemia from the carcinoid syndrome have increased basal adrenocortical function, I have determined the urinary free cortisol excretion of seventeen patients with carcinoid tumours and the carcinoid syndrome, twelve patients with carcinoid tumours without the carcinoid syndrome and seventeen normal subjects. There was no significant difference in the urinary free cortisol excretion of the patients with carcinoid tumours and the carcinoid syndrome (133 +/- 20.0 nmoles/24 h), patients with carcinoid tumours without the carcinoid syndrome (115 +/- 29 nmoles/24 h) and the normal subjects (96 +/- 9 nmoles/24 h). There was no correlation between the urinary free cortisol secretion and urinary 5-hydroxyindoleacetic acid or serum serotonin concentration in the patients with the carcinoid syndrome. There was a suggestion that patients with 5-hydroxytryptophan (5-HTP) secreting carcinoid tumours had higher urinary free cortisol excretion than patients with predominantly serotonin (5-HT) secreting carcinoid tumours. This may be due to the fact that the non-polar 5-HTP molecule penetrates the blood-brain barrier more effectively than the polar 5-HT molecule. 5-HTP is then converted to 5-HT within the brain. None of the twenty-nine patients with carcinoid tumours had clinical or laboratory evidence of the ectopic ACTH syndrome.

5-Hydroxytryptophan↗
PubMed1978

Primary carcinoid tumor of the testis: case report, ultrastructure and review of the literature.

A case of primary pure carcinoid tumor of the testis which occurred in a 71-year-old male is reported. The patient was treated by radical orchiectomy and remains well and symptom free 10 months after operation. Histologically as well as ultrastructurally the tumor showed typical appearances of carcinoid tumor of midgut derivation. 23 cases of carcinoid tumors of the testis were discovered in the literature. Of these 17 were primary testicular carcinoids, and 6 were metastatic to the testis. Of the 17 cases of primary carcinoid tumors, 14 were pure carcinoids and only 3 were associated with teratoma. None of the primary testicular carcinoids were associated with metastases and the prognosis after orchiectomy was excellent, thus indicating that no further therapy is necessary. The prognosis of patients with carcinoid metastatic to the testis is poor. In view of this it is very important to determine whether the tumor is primary or metastatic.

Aged↗
PubMed1979

Clinical study of 81 gastrointestinal carcinoid tumors.

The behavior and treatment of gastrointestinal carcinoid tumors have been the subject of much discussion. Size, location, and histologic invasiveness have been shown to correlate with regional and remote metastasis in previous series. We reviewed 81 patients with gastrointestinal carcinoids seen at the Medical University of South Carolina Teaching Hospitals since 1950. An unusual case of a 0.5 cm primary ileal carcinoid with widespread intra-abdominal and hepatic metastases is documented. In this series carcinoids were found (in order of decreasing frequency) in the ileum, appendix, rectum, right colon, duodenum, jejunum, stomach, ampulla of Vater, sigmoid colon, and pancreas. Metastases were found in 17% of the overall group. Two carcinoids presented with intussusception, while one was found within a Meckel's diverticulum. In addition to the small metastatic ileal carcinoid, one patient with a rectal carcinoid measuring 0.4 cm was found to have metastases after low anterior resection. Because all extra-appendiceal gastrointestinal carcinoids are potentially metastatic, it is stressed that regional lymphadenectomy en bloc with primary excision is the treatment of choice wherever feasible. If the lesion is small or has not invaded deeply, local excision with close follow-up may be an acceptable alternative.

Adolescent↗
PubMed1978

[Severe tricuspid insufficiency and primary carcinoid tumor of the ovary. Long term success after valve replacement. Apropos of a case].

The case is reported of carcinoid heart disease in a lady of 70 with intractable congestive cardiac failure 5 years after the removal of a primary carcinoid tumour of the ovary. The special features of primary carcinoid tumours of the ovary are recalled, with emphasis on their rarity and of the absence of liver metastases. The various features of carcinoid syndrome are recalled in the light of current knowledge of the pathogenesis. A review of the literature on cardiac involvement in primary carcinoid tumours of the ovary, amounting to 10 cases, is included. The possibility of surgical cure of the heart lesions in carcinoid tumour by a prosthetic tricuspid valve are discussed, in the light of the 6 reported cases and the present one. Our report is the first one of replacement of the valve after removal of a primary ovarien carcinoid tumour, and the excellent result has been maintained after three years.

Aged↗
PubMed1978

[The multiple stomach carcinoid].

Carcinoid tumors can be found in the entire alimentary tract. Stomach carcinoids make up about 3% of all carcinoids; 0.39% of all stomach tumors are carcinoids. Multiple stomach carcinoid is a medical rarity. In spite of an invasive growth, carcinoids with a diameter of less than 1 cm are considered semimalignant, those with a diameter of more than 1 cm are considered sure malignant. There are 8 cases of multiple gastric carcinoids described in the literature. In our case we found macroscopically 31 polyps with a diameter of between 0.4 and 2 cm in the stomach. Histologically they were growing invasively with small tumor groups in the lymph ducts. Therapeutically total gastrectomy was necessary.

Carcinoid Tumor↗
PubMedDate not supplied

Growth hormone and prolactin secretion in the carcinoid syndrome.

We evaluated plasma growth hormone (GH) and plasma prolactin (PRL) levels in ten patients with metastatic carcinoid tumors and the carcinoid syndrome ("active tumors") and seven patients with metastatic carcinoid tumors without the carcinoid syndrome ("inactive tumors"). The patients with active tumors had elevated serum serotonin levels and increased urinary 5-hydroxyindoleacetic acid (5-HIAA) while these values were normal in patients with inactive tumors. Forty-five per cent of patients with active tumors had elevated fasting plasma GH levels that were either not suppressed or showed a paradoxical increase in response to I.V. glucose. There was a positive correlation between the plasma GH levels and serotonin production by the tumor. Twenty-eight per cent of patients with inactive tumors had elevated fasting plasma GH levels. GH levels were decreased by the administration of serotonin antagonists in some but not all of the patients. Parachlorophenylalanine (PCPA) an inhibitor of serotonin synthesis caused a paradoxical rise in GH levels. GH release in response to insulin hypoglycemia was normal. Plasma prolactin levels were normal in most of the patients with metastatic carcinoid tumors. PCPA administration did not systematically alter plasma prolactin levels. We conclude that elevated plasma GH levels are frequently present in patients with the carcinoid syndrome. Both serotonin produced by the tumors and the tumor itself may be responsible for the elevated GH levels.

Adult↗
PubMed1975

Glucose intolerance in the carcinoid syndrome.

We assayed glucose tolerance and insulin secretion in ten patients with metastatic carcinoid tumors and the carcinoid syndrome ("active tumors") and in seven patients with metastatic carcinoid tumors without the carcinoid syndrome ("inactive tumors"). The patients with "active tumors" had elevated serum serotonin levels while the patients with "inactive tumors" had normal serum serotonin levels. Of the ten patients with "active tumors," five had diabetic and three had borderline intravenous glucose disposal rate constants (KG = 0.88 +/- 0.07, M. +/- S.E.M.). Their KG was significantly lower (p less than 0.01) than a group of age-matched normals. All of the patients with "inactive tumors" had normal KG values (KG = 1.67 +/- 0.24). Their KG did not differ from that of age-matched normal subjects. Both groups of carcinoid patients had a comparable decrease in their insulinogenic index. Two days' administration of the serotonin antagonist cyproheptadine (Cypro) to eight of the patients with "active tumors" resulted in a significant increase in the "insulinogenic index" (50%) but a nonsignificant increase in the KG (12%). Administration of p-chlorophenylalanine, a compound that blocks serotonin synthesis, resulted in an increase in both the KG (60%) and the "insulinogenic index" (55%). The insulin half-life (t1/2) of patients with "active tumors" (6.1 +/- 0.4 min.) did not differ from the t1/2 of normal subjects (6.6 +/- 0.4 min.), suggesting that the decreased plasma insulin levels following intravenous glucose were due to impaired insulin secretion rather than accelerated insulin destruction. Seven of the patients received treatment with the antitumor agent streptozotocin (Strepto). The patients received cumulative doses of from 70 to 300 mg. of Strepto per kilogram body weight with no impairment in glucose tolerance or insulin secretion. We conclude that there is high incidence of glucose intolerance (80%) and impaired insulin secretion in patients with the carcinoid syndrome and that serotonin plays a role in producing these alterations.

Adult↗
PubMed1978

Tracheal carcinoids.

Three cases of carcinoid tumor arising in the trachea are reported and contrasted with carcinoids arising in bronchi and carcinoids in general. Only eleven other documented examples of tracheal carcinoids are found in the English literature. The true prevalence of carcinoids primary in the trachea cannot be accurately determined from the literature because of imprecise nomenclature or because of the failure to distinguish this tumor from carcinoids primary in the bronchus. Presenting symptoms are hemoptysis, dyspnea and wheezing, often persisting for many years before the correct diagnosis is made. The treatment of choice is surgical resection of the involved segment of trachea and primary reconstruction. The prognosis is generally good. The tumor metastasized in one of our three cases and in none of the eleven cases in the English literature.

Adolescent↗
PubMed1978

[Malignant carcinoids of the stomach].

The work is concerned with the study of gastric tumors showing histological similarity with carcinoids, but differing from them by morphological and clinical signs of malignancy. A conclusion is made on the carcinoid nature of the neoplasms under consideration, the following evidences being presented: 1) despite some differences the tumors correspond histologically to classical carcinoids; 2) as in common carcinoids, argyrophil or argentaffine granules may be revealed in tumor cells; 3) the occurrences of tumors is related with a peculiar neoplastic transformation of glandular epithelium of the stomach resembling carcinoid rather than cancerous one. Not excluding the possibiltiy of their origin from common carcinoids, the author believes that they are likely to be primary malignant tumors.

Carcinoid Tumor↗
PubMed1979

Transplantable argyrophilic gastric carcinoid of Mastomys natalensis secreting both histamine and serotonin.

A transplantable strain of gastric carcinoids of Mastomys (Praomys) natalensis secreted not only histamine but also serotonin [5-hydroxytryptamine (5-HT)]. Mastomys bearing growing transplants excreted 11.3 times more histamine and 4.4 times more 5-hydroxyindole-3-acetic acid (5-HIAA) in the urine than did Mastomys in which transplanted tumors did not grow. Mastomys that developed primary gastric carcinoids also excreted 3.9 times more histamine than did those free from primary tumors, but the difference in urinary excretion of 5-HIAA was not significant in both groups. All transplantable carcinoids contained definite amounts of both histamine and serotonin, whereas the primary gastric carcinoids contained only histamine. We also confirmed that the histamine and 5-HIAA excreted in urine increased as the size of transplanted tumors enlarged. 5-HT was histochemically demonstrated in a small number of carcinoid cells of the transplanted tumors but not in primary carcinoids.

Animals↗