Carcinoid Tumors : Mnemonic

Origin: Neuroendocrine cells

Location: Lungs, Bronchi, Trachea, Gastrointestinal tract

Synthesize: Biogenic amines (mainly serotonin which is metabolied to 5-HIAA)

5 Manifestations

carcinoid syndrome
Mikael Häggström, CC0, via Wikimedia Commons

Mnemonic: 5-HIAAS

1. Heart disease (2/3 patients)

  • Right sided valvular heart lesions (due to factors secreted into hepatic vein by liver metastases)
    • Tricuspid regurgitation
    • Tricuspid stenosis
    • Pulmonary stenosis (less common)
  • Left sided heart disease (infrequent): 10%
  • Hypotension

2. Intestinal manifestations

  • Gastrointestinal bleeding
  • Obstruction
  • Watery diarrhea unresponsive to fasting

3. Airway obstruction

  • Localized wheezing +/- hemoptysis

4. Asthma

  • Significant diffuse wheezing

5. Skin manifestations

  • Intense cutaneous flushing
  • Necrolytic erythema

Alternative mnemonic: CARCinoid

  1. Cutaneous flushing
  2. Asthmatic wheezing
  3. Right sided valvular heart lesions
  4. Cramping and diarrhea

Rule of 1/3

  • 1/3 of carcinoid tumors metastasize.
  • 1/3 of carcinoid tumors present with 2nd malignancy.
  • 1/3 of carcinoid tumors are multiple.

Surgery for appendiceal carcinoid tumor

  1. <2 cm: Simple appendectomy
  2. >2 cm or mesoappendix invasion: Hemicolectomy

Medical therapy

  1. Somatostatin analogue: Octreotide
  2. Tryptophan hydroxylase inhibitor: Telotristat

One Viewpoint 💬 on “Carcinoid Tumors : Mnemonic”

  1. This is a great mnemonic. You’ve always delivered the best, God bless you for teaching and searching ❤️🙏🏾🤙

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