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1. Nikou GC, Lygidakis NJ, Toubanakis C, Pavlatos S, Tseleni-Balafouta S, Giannatou E, Mallas E, Safioleas M: Current diagnosis and treatment of gastrointestinal carcinoids in a series of 101 patients: the significance of serum chromogranin-A, somatostatin receptor scintigraphy and somatostatin analogues. Hepatogastroenterology; 2005 May-Jun;52(63):731-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Current diagnosis and treatment of gastrointestinal carcinoids in a series of 101 patients: the significance of serum chromogranin-A, somatostatin receptor scintigraphy and somatostatin analogues.
  • BACKGROUND/AIMS: Carcinoids are relatively rare tumors that arise from neuroendocrine cells and have proved to be slow growing malignancies which involve many organs and most frequently the gastrointestinal (GI) tract.
  • Herein we present in this study 101 pts with carcinoid tumors that originated from the GI tract and pancreas.
  • Also, we analyze the clinical and pathological features, pointing out the characteristics of this group of neoplasms and describing our diagnostic and therapeutical approach, in parallel with a brief review of the literature.
  • The primary tumors originated from the GI tract in 97/101 pts (appendix 34%, small intestine 31%, stomach 14%, duodenum 6%, colon 6%, rectum 3%) and from the pancreas in 4/101 (4%).
  • The diagnosis was confirmed histologically in all cases, after surgical excision of the primary tumor or by biopsies taken during endoscopy.
  • All pts were evaluated several times per year with clinical, biochemical and imaging assessments, including neuroendocrine markers [urinary 5-Hydroxyindoleacetic acid (5-HIAA), serum Chromogranin-A (CgA)] and Somatostatin Receptor Scintigraphy (OCTREOSCAN).
  • RESULTS: Patients were referred to us with gastrointestinal symptoms or symptoms of the "carcinoid syndrome" (flushing, and diarrhea), depending mainly on the location of the primary tumors and the existence or not of metastases.
  • CgA and 5-HIAA levels were increased especially in metastatic tumors.
  • Localization of the primary tumors to facilitate surgery was made by many imaging techniques (US, CT, MRI, Enteroclysis, OCTREOSCAN) and endoscopic procedures.
  • OCTREOSCAN was positive in 94% pts with metastatic disease.
  • Furthermore, it revealed the primary and the metastatic lesions in 16% and 33% of pts with carcinoids of the small intestine respectively, while other conventional imaging procedures (including MRI) were negative at the same time.
  • Seventy-four percent of the pts underwent a surgical resection of the primary tumor, while in 21%, an endoscopic polypectomy was performed.
  • All pts with metastatic tumors and positive OCTREOSCAN, were treated with Somatostatin analogues, which resulted in control of symptoms (75%), stabilization of tumor growth (71%) or tumor shrinkage (9%).
  • A combined therapy with the addition of interferon-a was initiated in pts in whom, despite the increase of drug dosage and the shortening of administration intervals, a complete clinical and biochemical response was no more achieved with Somatostatin analogues alone.
  • Pancreatic carcinoids and also those that originated from the proximal colon were found to have worst prognosis.
  • CONCLUSIONS: a) Tumor size (especially in appendiceal and gastric carcinoids) and, also, the dispersion of disease, highly predict the evolution of the patients;.
  • b) serum Chromogranin-A seems to be a very useful tumor marker for the diagnosis and follow-up of pts with GI carcinoids;.
  • c) the introduction of new imaging techniques and especially OCTREOSCAN contributes to a better localization of the primary tumors and their metastases, as well as, to the right decision of the appropriate medical treatment;.
  • d) surgical excision is the treatment of choice in nonmetastatic tumors; and e) in pts with metastatic disease, the administration of Somatostatin analogues improves their quality of life.
  • [MeSH-major] Biomarkers, Tumor / blood. Carcinoid Tumor / diagnosis. Chromogranins / blood. Gastrointestinal Neoplasms / diagnosis. Receptors, Somatostatin / blood. Somatostatin / analogs & derivatives
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Chromogranin A. Disease Progression. Female. Follow-Up Studies. Humans. Hydroxyindoleacetic Acid / blood. Male. Middle Aged. Palliative Care. Quality of Life

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  • (PMID = 15966194.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CHGA protein, human; 0 / Chromogranin A; 0 / Chromogranins; 0 / Receptors, Somatostatin; 51110-01-1 / Somatostatin; 54-16-0 / Hydroxyindoleacetic Acid; G083B71P98 / pentetreotide
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2. Nakamura S, Kimura S, Kashima M, Shichijo K, Yoshida S, Harada E, Matsushita T, Oshima Y, Tamaki Y, Horiuchi N, Takeichi T, Fujimoto H, Masuda K, Iwasaka N, Shinomiya S: [A case of peritonitis carcinomatosa from goblet cell carcinoid of the appendix treated by intraperitoneal paclitaxel and systemic S-1 chemotherapy]. Gan To Kagaku Ryoho; 2008 Dec;35(13):2425-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [A case of peritonitis carcinomatosa from goblet cell carcinoid of the appendix treated by intraperitoneal paclitaxel and systemic S-1 chemotherapy].
  • Goblet cell carcinoid of the appendix is a rare neoplasm and clinically tends to take a malignant course.
  • Abdominal computed tomography showed massive ascites and slight contrast enhancement of appendix.
  • A tumor was found by colonoscopic examination at the orifice of vermiform and was diagnosed pathologically as goblet cell carcinoid of the appendix.
  • We performed intraperitoneal paclitaxel(PTX)administration at 70 mg/m(2) week without any resection of the tumor.
  • Ascites were reduced immediately, but drug-induced interstitial pneumonia occurred due to PTX.
  • For about one year, her tumor was controlled but became worse thirteen months after diagnosis and died.
  • It is thought that intraabdominal paclitaxel administration and systemic S-1 therapy can be one of appropriate forms of chemotherapy for inoperable peritoneal carcinomatosis from goblet cell carcinoid of appendix.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoid Tumor / drug therapy. Carcinoid Tumor / pathology. Oxonic Acid / therapeutic use. Paclitaxel / therapeutic use. Peritonitis / drug therapy. Peritonitis / pathology. Tegafur / therapeutic use
  • [MeSH-minor] Aged. Colonic Neoplasms / complications. Colonic Neoplasms / drug therapy. Colonic Neoplasms / pathology. Colonic Neoplasms / surgery. Colonoscopy. Drug Combinations. Female. Humans. Injections, Intraperitoneal. Tomography, X-Ray Computed. Treatment Failure

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  • (PMID = 19098416.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; P88XT4IS4D / Paclitaxel
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3. Auer J, Kirchgatterer A, Berent R, Allinger S, Hinterholzer G, Höbling W, Meindl S, Oppitz P, Kalchmair J, Neuwirth G, Knoflach P: [Gastrointestinal hemorrhage needing blood transfusion as the first manifestation of small bowel carcinoid tumor]. Z Gastroenterol; 2000 Aug;38(8):631-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Gastrointestinal hemorrhage needing blood transfusion as the first manifestation of small bowel carcinoid tumor].
  • Carcinoid tumors arise from enterochromaffin or enterochromaffin-like cells that are present in the gastrointestinal tract, ovaries, and lungs.
  • Over 90% of carcinoids originate in the gastrointestinal tract with the most common sites in order of frequency being the appendix, terminal ileum, rectum, and the remainder of the colon.
  • Gastroduodenal and pancreatic carcinoids are infrequent.
  • Carcinoid syndrome is associated with small intestine carcinoids in about 40%.
  • Upper gastrointestinal bleeding with melaena or hematochezia is a relatively rare early symptom of patients with small intestine carcinoid tumors.
  • Laparotomy revealed bleeding from a small submucosal malignant carcinoid tumor in small intestine and multiple large metastases within mesenteric tissue.
  • Small intestinal carcinoid tumor has to be considered as a rare cause of gastrointestinal bleeding with melaena or hematochezia.
  • Nevertheless, bleeding is a relatively rare early symptom of patients with small intestine carcinoid tumor.
  • [MeSH-major] Blood Transfusion. Carcinoid Tumor / diagnosis. Gastrointestinal Hemorrhage / etiology. Intestinal Neoplasms / diagnosis. Intestine, Small
  • [MeSH-minor] Acenocoumarol / administration & dosage. Acenocoumarol / adverse effects. Aged. Diagnosis, Differential. Humans. Male. Protein S Deficiency / drug therapy. Protein S Deficiency / genetics. Recurrence


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4. Gilboa Y, Fridman E, Ofir K, Achiron R: Carcinoid tumor of the appendix: ultrasound findings in early pregnancy. Ultrasound Obstet Gynecol; 2008 May;31(5):576-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Carcinoid tumor of the appendix: ultrasound findings in early pregnancy.
  • Ultrasound examination of a woman in early pregnancy with right lower quadrant abdominal pain demonstrated an edematous appendix with amorphous fluid surrounding the appendix.
  • At laparotomy, these findings were confirmed.
  • On pathological evaluation following surgical removal of the appendix a rare case of carcinoid tumor of the appendix was diagnosed.
  • This is the first description of the transvaginal ultrasound features of a carcinoid tumor of the appendix.
  • [MeSH-major] Appendiceal Neoplasms / ultrasonography. Carcinoid Tumor / ultrasonography. Pregnancy Complications, Neoplastic / ultrasonography
  • [MeSH-minor] Abdominal Pain / etiology. Abortion, Spontaneous / drug therapy. Adult. Female. Humans. Pregnancy. Treatment Outcome

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  • [Copyright] Copyright (c) 2008 ISUOG
  • (PMID = 18393270.001).
  • [ISSN] 1469-0705
  • [Journal-full-title] Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
  • [ISO-abbreviation] Ultrasound Obstet Gynecol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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5. Miquel C, Sabourin JC, Elias D, Grandjouan S, Viguier J, Ducreux M, Duvillard P, Praz F: An appendix carcinoid tumor in a patient with hereditary nonpolyposis colorectal cancer. Hum Pathol; 2004 Dec;35(12):1564-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An appendix carcinoid tumor in a patient with hereditary nonpolyposis colorectal cancer.
  • Gastrointestinal carcinoid tumors are often associated with other tumors, particularly colon adenocarcinomas; but the association between carcinoid tumors and hereditary nonpolyposis colorectal cancer (HNPCC) syndrome has not yet been explored.
  • We report an unusual case of a 28-year-old woman with HNPCC who underwent surgery for a transverse colon adenocarcinoma in whom an appendix carcinoid tumor was incidentally found.
  • To assess whether the carcinoid tumor displayed the characteristic molecular features of HNPCC tumors, we investigated the expression of mismatch-repair (MMR) proteins and microsatellite instability (MSI) status in both tumors.
  • Both tumors demonstrated normal expression of the MMR proteins hMLH1, hMSH2, hMSH6, and hPMS2.
  • Interestingly, the adenocarcinoma exhibited an MSI phenotype but the carcinoid tumor did not, indicating that these 2 tumors arose through different molecular pathways.
  • [MeSH-major] Appendiceal Neoplasms / pathology. Carcinoid Tumor / pathology. Colonic Neoplasms / pathology. Colorectal Neoplasms, Hereditary Nonpolyposis / pathology
  • [MeSH-minor] Adult. Antimetabolites, Antineoplastic / therapeutic use. Chemotherapy, Adjuvant. DNA, Neoplasm / analysis. DNA-Binding Proteins / analysis. Drug Therapy, Combination. Female. Fluorouracil / therapeutic use. Humans. Leucovorin / therapeutic use. Microsatellite Repeats / genetics. Treatment Outcome

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  • (PMID = 15619218.001).
  • [ISSN] 0046-8177
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / DNA, Neoplasm; 0 / DNA-Binding Proteins; 0 / MSH3 protein, human; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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6. Schmidbauer S, Ladurner R, Jückstock H, Trupka AW, Mussack T, Hallfeldt KK: [Surgical and adjuvant therapy of neuroendocrine tumors of the gastrointestinal tract and their metastases. A retrospective analysis of personal patient group]. Chirurg; 2001 Aug;72(8):945-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Surgical and adjuvant therapy of neuroendocrine tumors of the gastrointestinal tract and their metastases. A retrospective analysis of personal patient group].
  • [Transliterated title] Die operative und adjuvante Therapie neuroendokriner Tumoren des Gastrointestinaltrakts und ihrer Metastasen. Eine retrospektive Analyse des eigenen Patientenguts.
  • INTRODUCTION: Carcinoid tumors are the most common neuroendocrine tumors of the gastrointestinal tract.
  • Surgical treatment and prognosis depend on the location of the tumor.
  • METHOD: Between 01.01.1985 and 31.12.1999 25 patients with neuroendocrine tumors of the gastrointestinal tract or their metastases were treated in our institution.
  • RESULTS AND CONCLUSIONS: The most frequent primary sites were the ileum and jejunum (36%), appendix (36%), stomach (12%), pancreas (8%), colon (4%) and bronchus with hepatic metastasis (4%).
  • A malignant carcinoid syndrome was present in 8 patients.
  • In patients with neuroendocrine tumors, curative, radical tumor removal should be attempted.
  • Some patients with advanced disease needed some surgery for tumor debulking and resection of metastases.
  • In non-resectable liver metastases hepatic arterial chemotherapy and chemoembolization after implantation of port catheters seem to be very beneficial therapeutic options.
  • A fixed part of the therapeutic regime in progressive disease is adjuvant chemotherapy with 5-fluorouracil and streptozotocin and symptomatic therapy with octreotide.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Gastrointestinal Neoplasms / surgery. Liver Neoplasms / secondary. Neuroendocrine Tumors / secondary
  • [MeSH-minor] Adult. Aged. Chemoembolization, Therapeutic. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Fluorouracil / adverse effects. Follow-Up Studies. Humans. Male. Malignant Carcinoid Syndrome / drug therapy. Malignant Carcinoid Syndrome / surgery. Middle Aged. Octreotide / administration & dosage. Octreotide / adverse effects. Retrospective Studies. Streptozocin / administration & dosage. Streptozocin / adverse effects. Treatment Outcome

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  • (PMID = 11554141.001).
  • [ISSN] 0009-4722
  • [Journal-full-title] Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
  • [ISO-abbreviation] Chirurg
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 5W494URQ81 / Streptozocin; RWM8CCW8GP / Octreotide; U3P01618RT / Fluorouracil
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