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  • Q&A with Australian Health Practitioners

    What is carcinoid syndrome?

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    Mr Dean Spilias

    Upper GI Surgeon (Abdominal)

    Dean graduated from the University of Melbourne in 1997 and went on to surgical training at the Royal Melbourne Hospital. During his residency he had … View Profile

    Carcinoid syndrome is the flushing/blushing, diarrhoea, and occasional breathlessness or oedema (swelling) that can occur in the presence of some neuroendocrine tumours of the type commonly called carcinoids

    A carcinoid is one type of tumour that can arise from neuroendocrine cells - cells that, in general, secrete hormones in response to nerve signals. Carcinoids can arise in various parts of the body, most commonly in the gut, but also in the lungs or other areas. The carcinoid cells secrete various hormones (serotonin, kallikrein) which the body breaks down into bradykinin, a chemical that causes the blood vessels to dilate (open up) and causes uncontrollable blushing, hot flushes and diarrhoea. The chemicals produced by the carcinoid can also cause scarring of the heart valves, leading to breathlessness or swelling, and can occasionally cause wheezing. 

    Most carcinoids do not cause carcinoid syndrome; the chemicals are broken down and detoxified by the liver. However, if there is enough kallikrein or serotonin that escapes detoxification, carcinoid syndrome can occur. This can happen if the carcinoid has spread from the gut to the liver; if the carcinoid arises in the lungs; or if the liver is not functioning well enough. 

    There are many more common causes of blushing and diarrhoea than carcinoid syndrome. If carcinoid syndrome is suspected, the usual test is a 24-hour urine collection which is tested for the presence of 5-HIAA, which is produced as the body breaks down serotonin. 

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