Neuroendocrine (Carcinoid) Tumor Symptoms
Clinical presentation
Some patients with advanced neuroendocrine tumors may remain symptom-free for years, others develop symptoms from either tumor bulk or hormonal hypersecretion.
Foregut
Bronchial carcinoids
- Cough, hemoptysis, postobstructive pneumonia, Cushing's syndrome. Carcinoid syndrome rare.
Gastric carcinoids
- Usually asymptomatic and found incidentally.
Midgut
Small intestine carcinoids
- Intermittent bowel obstruction or mesenteric ischemia. Carcinoid syndrome common when metastatic.
Appendiceal carcinoids
- Usually found incidentally. May cause carcinoid syndrome when metastatic.
Hindgut
Rectal carcinoids
- Either found incidentally or discovered because of bleeding, pain, and constipation. Rarely cause hormonal symptoms, even when metastatic.
In patients with metastatic carcinoid tumors, the secretion of serotonin and other vasoactive substances may cause carcinoid syndrome, which is manifested by episodic flushing, wheezing, diarrhea, and eventual right-sided valvular heart disease. Symptoms may also occur depending on the hormones produced, eg: Insulinomas, produce insulin which may cause hypoglycemia or low blood sugar. Glucagonomas can produce a very characteristic skin rash and gastrinomas can cause hypersecretion of acid in the stomach causing gastritis.
