Group: Diagnosis and Surveillance
What is an OctreoScan?
An OctreoScan is fairly straightforward. While it cannot give an indication as to tumor size, it can indicate the extent of disease metastasis and show possible loci for tumors which may or may not have been suspected. Essentially what happens is this:…
READ MORECan you provide some suggestions about the preferred use of OctreoScans?
An OctreoScan can very occasionally show a carcinoid before CT scan or chemistries indicate its presence, but this situation is very infrequent. Visually it is used to help locate a tumor when chemistries show it is present and CT scan doesn’t image…
READ MOREWhat hormones do carcinoid tumors secrete to produce the symptoms of carcinoid syndrome?
In general it can be stated that practically all carcinoid syndrome cases exhibit some increase in at least one of the many endocrine chemical products elaborated by the tumor and producing the syndrome. These include not only blood serotonin and urine…
READ MOREWhat tests are needed in the diagnosis of carcinoid or whatever it can be?
Octreoscan is the imaging technique of choice in addition to CT scan and MRI. In appropriate cases, Neotect Scan, FDG PET scan or F18 Dopa PET Scan and MIBG Scan in expert hands are useful. Measurement of urine and blood catecholamine could unmark a pheochromocytoma…
READ MOREHow do you determine if a carcinoid tumor is typical or atypical?
Eugene Woltering, MD, FACS, answers: ” Well, the procedure that I use is to:
1. Look at the path report and look for key words like mitotic indices necrosis and the key word differentiation.
2. Get a Ki -67 and clearly, the lower this number the better. …
Once we have been diagnosed with carcinoid, what should the follow-up surveillance program include? Which tests and how often?
Chemical markers are important to measure and follow since they change before imaging tests do and before physical conditions (symptoms) change. They are useful early indicators of the tumor status.
The tempo of the disease varies from one patient to…
If I have anaphylactic episodes, with flushing, diarrhea & low blood pressure, could I have carcinoid syndrome?
I can provide some general suggestions that should be useful, as regulations restrict me from answering specific questions. Carcinoid crisis is characterized by abrupt flushing of face and sometimes upper body, usually severe fall in blood pressure…
READ MOREIf I have a patient with severe asthma, facial flushing, and elevated serum 5-HIAA, could this be carcinoid syndrome?
It can be carcinoid syndrome. How high is the 5-HIAA and was the urine collected on a serotonin-free diet? If it was more than just slightly elevated, then confirm its significance by testing blood serotonin, which should be increased; blood tryptophan,…
READ MOREWhich symptoms need to be present to diagnose carcinoid syndrome?
Carcinoid syndrome requires one or more of the following for laboratory confirmation of the diagnosis: increased blood serotonin with decreased blood tryptophan, increased chromogranin A and increased urine 5HIAA or indole-3-acetic acid. In spite…
READ MOREWhat other conditions are similar to carcinoid?
Pheochromocytoma, mast cell disease, gastrointestinal allergies, VIPoma, medullary carcinoma of the thyroid, certain rare brain tumors and also certain rare neuropsychiatric disorders, to mention a few.…
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