Climacteric flushing in a patient with carcinoid tumour

Area of Science:

• Endocrinology
• Oncology
• Gastroenterology

Background:

• Carcinoid tumors can cause carcinoid syndrome, often associated with flushing.
• Hormonal changes, such as those following orchiectomy, can also induce flushing reactions.

Observation:

• A 70-year-old male patient presented with frequent flushing attacks.
• He had a histologically verified carcinoid tumor and a history of orchiectomy for prostate cancer.
• Laboratory tests showed normal serotonin production and 5-hydroxyindoleacetic acid excretion.

Findings:

• The patient's flushing episodes mimicked climacteric flushing.
• Treatment with oral diethylstilbestrol resulted in a complete and rapid remission of flushing.
• The flushing was attributed to post-orchiectomy hormonal changes rather than the carcinoid tumor.

Implications:

• This case highlights the importance of considering hormonal fluctuations in patients with carcinoid tumors presenting with flushing.
• Diethylstilbestrol can be an effective treatment for post-orchiectomy climacteric flushing.
• Distinguishing flushing causes is crucial for appropriate patient management.