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| Approximately 1,000 cases are seen each year in the United Kingdom. Carcinoid tumors arise from glandular endocrine-hormone producing cells that are widely distributed within the body but found in greatest amounts in the small intestine and then in decreasing amounts in the appendix, rectum, lung, pancreas and very rarely in the ovaries, testes, liver, bile ducts or other locations. Almost all of these tumors make serotonin and bradykinin. In some cases they cause obscure intestinal bleeding or sometimes don't declare themselves until they cause painful enlargement of the liver due to large deposits of carcinoid metastases that have spread to that organ. A now universally approved (though costly) way of finding carcinoid tumors, as well as other neuroendocrine tumors, is the OctreoScan. It is successful in 85% of carcinoids and consists of a (probably) harmless injection of a minute dose of a short duration radioactive isotope which is specifically attracted to, and concentrated in, carcinoid tumor tissue (and any other neuroendocrine tumor) where it lights up during a radiation scan of the entire body. In most cases a firm diagnosis has not been established before an operative procedure has been performed. Carcinoid tumors vary greatly in their size, location, symptoms and growth, and therefore the treatment in each case should be individualized to what is best for each particular patient. |
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