"Carcinoid"

Carcinoid syndrome Skip to main contentSkip to searchLog inEnglishWe're showing you BMJ Best Practice in English. Click here to change your language.Please note: changing your language may affect units of measurement for drug dosages, drug names, spelling and choice of guidelines#{autosuggest.search}#{autosuggest.search}Carcinoid syndrome MENULog in or subscribe to access all of BMJ Best acid. Chromogranin A is often elevated in the presence of liver metastases.Treatments include medical therapies (somatostatin analogues, radionuclide therapies) and surgical options (resection of primary and secondary tumours).Complications include carcinoid heart disease and carcinoid crisis at times of stress (e.g., during surgery).DefinitionCarcinoid syndrome occurs due to release of serotonin (5

Telotristat for treating carcinoid syndrome diarrhoea (adults) NHS England » Telotristat for treating carcinoid syndrome diarrhoea (adults) Skip to main content Cookies on the NHS England websiteWe’ve put some small files called cookies on your device to make our site work.We’d also like to use analytics cookies. These send information about how our site is used to a service called Google on the coronavirus is here.If you are a member of the public looking for information and advice about coronavirus (COVID-19), including information about the COVID-19 vaccine, go to the NHS website. You can also find guidance and support on the GOV.UK website.Telotristat for treating carcinoid syndrome diarrhoea (adults)Document first published: 9 July 2020 Page updated: 22 July 2020 Topic: Commissioning, Medicine

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Development and evaluation of a multivariable prediction model for overall survival in advanced stage pulmonary carcinoid using machine learning. Evidence is limited on whether patients with advanced pulmonary carcinoid (APC) benefit from comprehensive pulmonary resection (CPR), chemotherapy, or radiotherapy. Existing prognostic models for APC are limited and do not guide treatment selection

Pathological & radiological variables in the diagnosis of bronchopulmonary carcinoids (BPCs) with a focus on Antigen Kiel 67 (Ki-67) proliferation index. Bronchopulmonary carcinoids (BPCs) are classified into typical carcinoids (TC) and atypical carcinoids (AC), based on the mitotic count and absence/presence of necrosis on pathology specimens. There are limitations to accurate measurement of these criteria. It important to study other markers like Ki-67, to enhance the diagnostic accuracy of lung carcinoids. Retrospective analysis of BPCs treated with surgery between 2012-2022, to examine the accuracy of Ki-67 on the diagnostic specimen, concordance of diagnostic and resection specimens, diagnostic accuracy of Positron Emission Tomography (PET) and concordance of clinical and pathological staging

Carcinoid syndrome Carcinoid syndrome - Symptoms, diagnosis and treatment | BMJ Best PracticeSkip to main contentSkip to search * About us * Help * Subscribe * Access through your institution * Log inBMJ Best Practice * Help * Getting started * FAQs * Contact us * Recent updates * Specialties * Calculators * Patient leaflets * Videos * Evidence * Drugs * Recent updates of primary and secondary tumours).Complications include carcinoid heart disease and carcinoid crisis at times of stress (e.g., during surgery).DefinitionCarcinoid syndrome occurs due to release of serotonin (5-hydroxytryptamine) and other vasoactive peptides into the systemic circulation from a carcinoid tumour. A total of 20% to 30% of midgut neuroendocrine tumours (NETs), 5% of bronchial carcinoid

Prognostic Immunohistochemistry for Ki-67 and OTP on Small Biopsies of Pulmonary Carcinoid Tumors: Ki-67 Index Predicts Progression-free Survival and Atypical Histology. Prognostic stratification of pulmonary carcinoids into "typical" and "atypical" categories requires examination of large tissue volume. However, there is a need for tools that provide similar prognostic information on small biopsy samples. Ki-67 and OTP immunohistochemistry have shown promising prognostic value in studies of resected pulmonary carcinoids, but prognostic value when using biopsy/cytology specimens is unclear. Ki-67 immunohistochemistry was performed on small biopsy/cytology specimens from pulmonary carcinoid tumors (n=139), and labeling index was scored via automated image analysis of at least 500 cells

Comparison of Octreotide and Vasopressors as First-Line Treatment for Intraoperative Carcinoid Crisis. Intraoperative carcinoid crisis is typically sudden onset of profound hypotension during operations on patients with neuroendocrine tumors. The crisis was thought to be due to massive release of hormones, and perioperative octreotide was recommended as a prophylaxis against the crisis and as first-line treatment. Recent studies show that octreotide does not prevent the crisis and that no massive release of hormones occurs. Therefore, the authors hypothesized that octreotide is not effective for treating the crisis. A prospective carcinoid anesthesia database was analyzed for occurrences of crisis. Outcomes were compared between protocols when first-line therapy was bolus octreotide

Anesthetic key points in a patient with a terminal ileum neuroendocrine tumor and a rare carcinoid left heart disease presented for non-cardiac surgery: case report. Carcinoid tumors are rare neuroendocrine malignancies presenting in an increasing number in our center. The incidence of carcinoid tumors is approximatively between 2.5 and 5 cases per 100,000 people of whom about 50% develop carcinoid syndrome. Once the carcinoid syndrome has developed, a carcinoid cardiomyopathy can occur. Carcinoid heart disease (CaHD) remains a serious and rare complication associated with a significant increase in morbidity and mortality. Although carcinoid tumors have been known and studied for several years, there are still scarce data on the anesthetic management and the peri operative period. We

Factors Associated With Long-term Survival in Children With Bronchial and Lung Carcinoid Tumors. Bronchial carcinoids are rare in children and the treatment is based on tumor behavior in adults. The purpose of this study was to determine factors and management strategies associated with long-term survival in the pediatric population using a national cohort. Patients aged ≤20 years with bronchial carcinoid tumors were identified in the 2004-2020 National Cancer Database using ICD-O-3 codes. Tumor characteristics and management were compared among typical (TC) and atypical (AC) histological subtypes using Chi-square and Fisher's exact tests. Kaplan-Meier and univariate Cox proportional hazards analyses were used to assess survival. Of 273 patients, 251 (92%) had TCs, and 22(8%) had ACs. The median

Disease relapse in relation to lymph node sampling in lung carcinoid patients. The predictive value of extent of per-operative lymph node (LN) sampling in relation to disease relapse in patients with pulmonary carcinoid (PC) is unknown. Furthermore, post-surgery follow-up recommendations rely on institutional retrospective studies with rather short follow-up. We aimed to address these short factors were atypical carcinoid, pN1/2 and R1/R2 resection. In 546 patients LN dissection data could be retrieved; at least one N2 LN was examined in 44% and completeness according to ESTS in merely 7%. In 477 cN0 patients, 5.9% had pN1 and 2.5% pN2 disease. In this population-based cohort, relapse occurred in 10% of PC patients with a median RFI of 48.1 months thereby underscoring the necessity of long

TERT Expression and Clinical Outcome in Pulmonary Carcinoids. The clinical course of pulmonary carcinoids ranges from indolent to fatal disease, suggesting that specific molecular alterations drive progression toward the fully malignant state. A similar spectrum of clinical phenotypes occurs in pediatric neuroblastoma, in which activation of telomerase reverse transcriptase () is decisive in determining the course of disease. We therefore investigated whether expression defines the clinical fate of patients with pulmonary carcinoid. expression was examined by RNA sequencing in a test cohort and a validation cohort of pulmonary carcinoids (n = 88 and n = 105, respectively). A natural expression cutoff was determined in the test cohort on the basis of the distribution of expression, and its

Circulating Chromogranin A as Surveillance Biomarker in Patients with Carcinoids - The CASPAR Study. Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are relatively indolent but can be more aggressive. The current recommendations for the use of serum CgA for GEP-NET patients are equivocal. This study was designed to validate an automated CgA immunofluorescence assay for monitoring disease

Serum and Urinary 5-hydroxyindolacetic acid, Serotonin, Chromogranin A, and NT-proBNP for the detection of Carcinoid Heart Disease. The aim of this study was to evaluate the performance of different biomarkers for the detection of carcinoid heart disease (CHD) in neuroendocrine tumours (NETs), in particular serum 5-HIAA (s5HIAA). An explorative ancillary study of the French CrusoeNET cohort

Identification of defined molecular subgroups based on immunohistochemical analyses and potential therapeutic vulnerabilities of pulmonary carcinoids. Multi-omic studies have identified three molecular separated pulmonary carcinoid (PC) subgroups (A1, A2, B) with distinctive mRNA expression profiles (e.g. OTP/ASCL1/HNF1A). We aimed to establish an immunohistochemical (IHC) biomarker panel that enables subgroup identification, and assessment of its potential clinical relevance. All patients with resected pulmonary carcinoids (2003-2012) were identified from the Dutch Cancer/Pathology Registry, and tumors were revised. The IHC expression of OTP/ASCL1/HNF1A was scored in a blinded fashion in a mRNA-profiled (n=5/subgroup) and national carcinoid cohort (n=478). Expression of potential therapeutic

Radiological follow-up in patients with resected pulmonary carcinoids: Should we reduce radiation exposure? After primary resection of pulmonary carcinoids, the recurrence rate is low (approximately 10 %). However, long-term radiological follow-up is generally recommended due to the risk of late recurrence. This must be weighed against risk of radiation-induced cancer, particularly in young patients. The frequency and modality of radiological follow-up according to the ENETS, ESMO, and CommNETs-NANETS guidelines were assessed. Cumulative radiation exposure per guideline and subsequent increased lifetime cancer risk were estimated using sex- and age-dependent risk factors. Data from the Netherlands Cancer Registry (2003-2012) of adults with resected pulmonary carcinoids were used

Gut microbial and functional alterations lead to metagenomic signatures for midgut neuroendocrine tumor patients and for carcinoid syndrome. Midgut neuroendocrine tumors (NET) derive from enterochromaffin cells, which have an close interrelationship with intestinal microbiota. Recently, we utilized 16S rRNA sequencing to uncover that midgut NET patients have a depleted gut microbiome and a specific fecal microbial signature. This study aims to validate these findings and to further characterize the role of microbes and microbial metabolic pathways in midgut NET patients with and without carcinoid syndrome (CS). Fecal samples from 60 midgut NET patients and 20 household-matched controls were subjected to whole metagenomics sequencing. We found that the gut microbial community composition

Clinic and genetic similarity assessments of atypical carcinoid, neuroendocrine neoplasm with atypical carcinoid morphology and elevated mitotic count and large cell neuroendocrine carcinoma. Pulmonary neuroendocrine neoplasms can be divided into typical carcinoid, atypical carcinoid, large cell neuroendocrine carcinoma, and small cell (lung) carcinoma. According to the World Health Organization , these four neoplasms have different characteristics and morphological traits, mitotic counts, and necrotic status. Importantly, "a grey-zone" neoplasm with an atypical carcinoid-like morphology, where the mitotic rate exceeds the criterion of 10 mitoses per 2 mm, have still not been well classified. In clinical practice, the most controversial area is the limit of 11 mitoses to distinguish between atypical

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Clinical characteristics and survival outcomes in patients with primary ovarian carcinoid: A historical cohort study. Primary ovarian carcinoids are extremely rare ovarian tumors, and there is limited data available on their clinical characteristics and survival outcomes. We conducted a historical cohort study of 56 patients to investigate their clinical characteristics. The overall survival , disease-specific survival, recurrence-free survival, and potential prognostic factors of these patients were also evaluated. The median age of these patients was 42.0 years (range: 20-71). The average mass and carcinoid size was 7.3 and 0.4 cm, respectively. Elevated tumor marker levels and ascites were observed in 15 and 10 patients, respectively. In 98.2% of the patients, tumors were confined