Carcinoid heart disease

Area of Science:

• Oncology
• Gastroenterology
• Endocrinology

Background:

• A 59-year-old female patient was diagnosed with metastatic carcinoid tumor of the terminal ileum in May 2003.
• The patient underwent extensive surgical resection including hemicolectomy, cholecystectomy, distal pancreatectomy, and splenectomy due to metastatic disease in the pancreas, mesentery, and liver.

Observation:

• The patient's tumor was functional, exhibiting hormonal hypersecretion.
• Symptoms included flushing, diarrhea, bronchospasm, and abdominal pain.
• Intermittent pleural effusions and a trace pericardial effusion were noted, not requiring intervention.

Findings:

• Over eight years, the patient received multiple treatments: octreotide, everolimus, oxaliplatin, and hepatic artery embolizations.
• Recent treatment involved capecitabine and bevacizumab with monthly octreotide.
• The case highlights the complex management of metastatic carcinoid tumors.

Implications:

• This case underscores the challenges in managing advanced, functional neuroendocrine tumors.
• It demonstrates the multidisciplinary approach required for long-term patient care.
• Understanding tumor behavior and treatment response is crucial for optimizing outcomes in metastatic carcinoid disease.