There are many possible causes of edema in association with carcinoid involving the liver. These include: low serum albumin due to carcinoid impairing the liver’s synthetic function, impaired liver function due to chemotherapy, interference with circulation to or from the liver by pressure of carcinoid tumor on the blood vessels or from clotting of blood in the vessels due to substances released by the tumors, congestive failure of the right side of the heart due to carcinoid heart valve disease, pellagra due to tryptophan deficiency resulting from the tumors abnormal utilization of tryptophan, malabsorption due to hormone-induced small intestine pathophysiology, peritoneal spread of carcinoid tumor, retroperitoneal spread of carcinoid tumor with lymphatic obstruction, and a number of other possible causes. The treatment in each instance is somewhat different and hence must be customized for each case. The edema is not a separate disease but part of the entire carcinoid disease spectrum.
