Carcinoid Tumors: from the Past into the Future

Carcinoids are a rare and slow growing tumor, having a propensity to affect all organs but most commonly involve the gastrointestinal tract, followed by lungs. Carcinoid tumors secrete a variety of peptides and neuroamines. Though clinical presentation is varied and depends on the involved organ along with produced neuroactive amines, common symptoms include flushing, explosive watery diarrhoea and bronchospasm. Estimation of 5-HIAA in 24-hour urine is highly specific. Serum chromogranin is highly sensitive even in non-secretory carcinoids. Octreoscan along with MIBG is a better diagnostic modality as compared to computed tomography or magnetic resonance imaging alone. Treatment involves a multidisciplinary approach, including resection of primary tumor and debulking, embolisation of liver carcinoids, somatostatin analogues and chemotherapy. Molecular target therapy with Sunitinib and Bevacizumab have been shown to have a promising role in treatment, with higher response rate and slower progression.