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</div><div><span>Carcinoid syndrome</span></div></div>
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</a><h1 class="with-also" itemprop="name">Carcinoid syndrome</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Carcinoid syndrome is a group of symptoms associated with carcinoid tumors. These are tumors most often of the small intestine, colon, appendix, or bronchial tubes in the lungs.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Carcinoid syndrome is the pattern of symptoms sometimes seen in people with carcinoid tumors. These tumors are rare, and often slow growing. Most carcinoid tumors are found in the gastrointestinal tract and lungs.</p><p>Carcinoid syndrome occurs in very few people with carcinoid tumors, after the tumor has spread to the liver or lung.</p><p>These tumors release too much of the hormone <a test="test" href="./003562.htm">serotonin</a>, as well as several other chemicals. The hormones cause the blood vessels to open (dilate). This causes carcinoid syndrome.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>The carcinoid syndrome is made up of four main symptoms including:</p><ul><li>Flushing (face, neck, or upper chest), or widened blood vessels seen on the skin (<a test="test" href="./003284.htm">telangiectasias</a>)</li><li>Difficulty breathing, such as wheezing</li><li>Diarrhea</li><li>Heart problems, such as leaking heart valves, slow heartbeat, low or high blood pressure </li></ul><p>Symptoms are sometimes brought on by physical exertion, or eating or drinking things such as blue cheese, chocolate, or red wine.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Most of these tumors are found when tests or procedures are done for other reasons, such as during abdominal surgery.</p><p>If a physical exam is done, the health care provider may find signs of: </p><ul><li>Heart valve problems, such as <a test="test" href="./003266.htm">murmur</a></li><li>Niacin-deficiency disease (<a test="test" href="./000342.htm">pellagra</a>)</li></ul><p>Tests that may be done include:</p><ul><li><a test="test" href="./003612.htm">5-HIAA</a> levels in urine</li><li>Blood tests (including <a test="test" href="./003562.htm">serotonin</a> and chromogranin blood tests)</li><li><a test="test" href="./003330.htm">CT</a><a test="test" href="./003335.htm">MRI</a> scan of the chest or abdomen</li><li><a test="test" href="./003869.htm">Echocardiogram</a></li><li>PET scan</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Surgery to remove the tumor is usually the first treatment. It can permanently cure the condition if the tumor is completely removed.</p><p>If the tumor has spread to the liver, treatment involves either of the following: </p><ul><li>Removing areas of liver that have tumor cells</li><li>Sending (infusing) medicine directly into the liver to destroy the tumors</li></ul><p>When the entire tumor can't be removed, removing large portions of the tumor ("debulking") can help relieve the symptoms.</p><p>Octreotide (Sandostatin) or lanreotide (Somatuline) injections are given to people with advanced carcinoid tumors that can't be removed with surgery.</p><p>People with carcinoid syndrome should avoid alcohol, large meals, and foods high in tyramine (aged cheeses, avocado, many processed foods), because they may trigger symptoms.</p><p>Some common medicines, like selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil) and fluoxetine (Prozac), may make symptoms worse by increasing levels of serotonin. However, do not stop taking these medicines unless your provider tells you to do so.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Support Groups</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Learn more about carcinoid syndrome and get support from:</p><ul><li>The Carcinoid Cancer Foundation -- <a class="extln" target="_blank" href="https://www.carcinoid.org/resources/support-groups/directory/">www.carcinoid.org/resources/support-groups/directory/</a></li><li>Neuroendocrine Tumor Research Foundation -- <a class="extln" target="_blank" href="https://netrf.org/for-patients/">netrf.org/for-patients/</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>The outlook in people with carcinoid syndrome is sometimes different from the outlook in people who have carcinoid tumors without the syndrome.</p><p>Prognosis also depends on the site of tumor. In people with the syndrome, the tumor has usually spread to the liver. This lowers the survival rate. People with carcinoid syndrome are also more likely to have a separate cancer (second primary tumor) at the same time. Overall, the prognosis is usually excellent.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Complications of carcinoid tumors may include:</p><ul><li>Increased risk of falls and injury (from low blood pressure)</li><li><a test="test" href="./000260.htm">Bowel obstruction</a> (from tumor)</li><li><a test="test" href="./003133.htm">Gastrointestinal bleeding</a></li><li>Heart valve failure</li></ul><p>A fatal form of carcinoid syndrome, carcinoid crisis, may occur as a side effect of surgery, anesthesia or chemotherapy.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Contact your provider for an appointment if you have symptoms of carcinoid syndrome.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-9" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-9"><p>Treating the tumor reduces the risk of carcinoid syndrome.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Flush syndrome; Argentaffinoma syndrome</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9877t.jpg" alt="Serotonin uptake" title="Serotonin uptake" class="side-img"/><a href="../imagepages/9877.htm">Serotonin uptake</a></li>
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</div></div><div class="section-body" id="section-Ref"><p>National Cancer Institute website. Gastrointestinal carcinoid tumors treatment (Adult) (PDQ) - health professional version. <a href="https://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq" target="_blank">www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq</a>. Updated August 19, 2022. Accessed October 13, 2022.</p><p>Öberg K. Neuroendocrine tumors and related disorders. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. <em>Williams Textbook of Endocrinology.</em> 14th ed. Philadelphia, PA: Elsevier; 2020:chap 45.</p><p>Wolin EM, Jensen RT. Neuroendocrine tumors. In: Goldman L, Schafer AI, eds. <em>Goldman-Cecil Medicine.</em> 26th ed. Philadelphia, PA: Elsevier; 2020:chap 219.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 8/15/2022</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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