Carcinoid syndrome

Incidence: 1 per 500 000 per year.


  1. intermittent cyanotic flushing
  2. diarrhoea & vomiting, abdominal cramps
  3. bronchoconstriction: cough, wheeze, dyspneoa
  4. pulmonary stenosis, tricuspid regurgitation (smooth muscle plaques deposited in endocardium).
  5. hepatomegaly (metastases)

May also present with features of ↑gastrin, ↑ACTH, ↑insulin.

Δx. excess 5HIAA in 24h urine.


Neuroendocrine tumours of
  1. appendix
  2. rectum
  3. lungs (usually central)
  4. ileum, stomach, colon
  5. pancreas
  6. biliary tree
  7. liver
Midgut tumours 50%. Bronchial tumours 10%. Gut carcinoids are silent unless they metastasise to the liver.


  1. Surgical resection
  2. Symptomatic relief Rx. octreotide
  3. Tumour targetted radiotherapy with 131I-MIBG