- carcinoid syndrome occurs in 5% of carcinoid tumor (with liver metastasis)
- associated with cardiac abnormality (TS/TR, PS/PR - accumulation of fibrous tissue in heart)
- presents with flushing, bronchospasm, diarrhea
- can present with acute appendicitis (obstruction of lumen by carcinoid)
- Pellagra syndrome is a complication (3Ds - dementia, diarrhea and dermatitis). Because carcinoids utilise tryptophan, a nicotinamide precursor - causing nicotinic acid deficiency.
- Investigations: urinary 5-HIAA (100% specificity), plasma chromogranin A (100% sensitivity), ultrasound liver
(Foods that can interfere the test includes bananas, eggplant, avocado and walnuts - avoid for 3 days before the test)
- Treatment : octreotide, appendicectomy, hepatic artery ligation/embolization
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