Group: Diagnosis and Surveillance
If I have been diagnosed with carcinoid syndrome due to a high 5-HIAA & symptoms, but nothing shows on a CT scan, what’s next?
If I understand your question correctly, you state that a diagnosis of carcinoid syndrome is suspected because of symptoms and high urine 5-HIAA, but the CT scan is normal and you want to know what other tests should now be done to prove the diagnosis. Failure…
READ MOREI would like to know if taking a PPI (Nexium) will alter the chromogranin A count?
Our Medical Director, Richard R.P. Warner MD, states that ALL PPI’s (example, Nexium) will alter CgA results and
should therefore be withheld for about 1 month prior to the chromogranin A (CgA) test. Zantac or Tagamet can be substituted during this…
Why do 5-HIAA urine tests sometimes come back high and other times low after carcinoid tumors have been removed?
The urine 5-HIAA test for carcinoid is crude and can be strongly influenced by special diet and drugs. The patient must be on a special diet before and during the urine collection. Even then the test can miss up to 50% of the cases. It should not be relied on …
READ MOREIf the 5-HIAA test misses up to 50% of carcinoid tumors, does this refer to both symptomatic & asymptomatic carcinoid tumors?
Urine 5-HIAA will correctly diagnose almost all midgut carcinoid tumors causing carcinoid syndrome but only 1/2 of foregut carcinoids causing an endocrine syndrome and almost none of the hindgut carcinoid (which rarely cause any endocrine syndrome…
READ MOREDoes 5-FU effect the 5-HIAA test?
5-FU is a form of chemotherapy. It might shrink a carcinoid and hence lower 5-HIAA in the urine, but it also can cause a transient increase in 5-HIAA since more is released temporarily by decaying tumors. However, the drug itself does not interfere with …
READ MOREDoes Levovist, an ultrasound contrast agent made up of milk sugar (galactose), work for carcinoid in imaging tests?
This is a contrast agent to help sonographic imaging of the portal vein and certain types of liver tumors (hepatocellular carcinoma – HCC). It does not have current immediate application in carcinoid disease since there is very limited or no experience…
READ MOREIs a colonoscopy to rule out GI lesions or an OctreoScan required after removal of an appendix with a small carcinoid?
If the carcinoid was greater than 1.5 cm diameter, or if it extended through the appendiceal wall to the serosa or the fat regardless of size, or if mesoappendix or nodes involvement were present – a right hemicolectomy should be done preceded by …
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