Carcinoid tumor and carcinoid syndrome

Area of Science:

• Oncology
• Anesthesiology
• Cardiology

Background:

• Carcinoid tumors secrete vasoactive substances like serotonin and bradykinin.
• These substances can cause life-threatening intraoperative reactions, including hypotension and bronchoconstriction.
• Carcinoid heart disease is prevalent in carcinoid syndrome, posing significant anesthetic challenges.

Purpose of the Study:

• To review the diagnostic and therapeutic dilemmas associated with carcinoid tumors and carcinoid syndrome in anesthesia.
• To highlight the role of octreotide in managing carcinoid-related adverse effects.
• To discuss the increasing incidence of carcinoid heart disease and associated cardiac valve surgery.

Main Methods:

• Review of current literature on carcinoid tumors, carcinoid syndrome, and anesthesia.
• Analysis of diagnostic techniques for carcinoid tumors.
• Evaluation of octreotide therapy and echocardiographic findings in carcinoid heart disease.

Main Results:

• Carcinoid tumors are more common than previously thought.
• Octreotide therapy improves survival and reduces carcinoid crises.
• Carcinoid heart disease, characterized by tricuspid and pulmonary insufficiency, is highly prevalent, leading to increased cardiac valve surgeries.

Conclusions:

• An increasing number of patients with carcinoid tumors and syndrome require anesthesia and surgery.
• Somatostatin analogues like octreotide are the preferred treatment for carcinoid tumor product-induced adverse effects.
• Management requires a multidisciplinary approach addressing oncologic, cardiovascular, and anesthetic aspects.