Carcinoid Syndrome and Perioperative Anesthetic Considerations

Rarity and review: evidence-based practice for uncommon diseases

“…1 Several classification systems attempt to describe these diverse diseases, 2,3 although discussions restricted to carcinoid tumours often focus on the embryological origin of the parent tissue: foregut (thymus, esophagus, lung, stomach, duodenum, pancreas), midgut (appendix, ileum, cecum, ascending colon), and hindgut (distal large bowel, rectum). 4 Carcinoid tumours are capable of secreting a variety of vasoactive substances, including serotonin, histamine, and kinin peptides, although only 25% do this, 5 and only 10% result in carcinoid syndrome. 6 Characterized by flushing, diarrhea, abdominal pain, and bronchoconstriction, carcinoid syndrome occurs when the tumour's metabolic products escape hepatic metabolism by either metastasis or primary locations outside the portal circulation.…”

Carcinoid Crisis in a Patient without Previous Carcinoid Syndrome: Perioperative Management and Anesthetics Considerations - A Case Report

“…They have origin in the cells of the neuroendocrine system and they are capable of releasing bioactive substances in the systemic circulation [1][2][3]. Carcinoid syndrome may occur when these substances reach systemic circulation without first being metabolized by the liver [1]. Usually, the syndrome develops from the liver metastases associated with primary carcinoids, or from primary tumors that do not drain into the portal system, bypassing hepatic metabolism [1,2].…”

“…Carcinoid syndrome may occur when these substances reach systemic circulation without first being metabolized by the liver [1]. Usually, the syndrome develops from the liver metastases associated with primary carcinoids, or from primary tumors that do not drain into the portal system, bypassing hepatic metabolism [1,2]. The clinical spectrum of carcinoid syndrome includes cutaneous flushing, diarrhea, hypo or hypertension, bronchoconstriction and carcinoid heart disease [1,3].…”

“…They have origin in the cells of the neuroendocrine system and they are capable of releasing bioactive substances in the systemic circulation [1][2][3]. Carcinoid syndrome may occur when these substances reach systemic circulation without first being metabolized by the liver [1].…”

“…Usually, the syndrome develops from the liver metastases associated with primary carcinoids, or from primary tumors that do not drain into the portal system, bypassing hepatic metabolism [1,2]. The clinical spectrum of carcinoid syndrome includes cutaneous flushing, diarrhea, hypo or hypertension, bronchoconstriction and carcinoid heart disease [1,3]. A carcinoid crisis is a life-threatening form of carcinoid syndrome with multiple precipitants known in the perioperative period [1].…”