Argentaffin associated with the carcinoma carcinoid syndrome

Abstract

Argentaffin carcinomata or carcinoid tumours are not common neoplasms. The carcinoid syndrome in which the systemic effects of excessive serotonin secretion by the tumour are demonstrable, is even rarer and occurs in 6% of all such tumours. The typically slow growth of carcinoid tumours is illustrated in this case by the 10-year survival of the patient after the onset of symptoms. When resected, the small jejunal tumour had been causing symptoms for five years and had not yet overtly metastasised. The periodic estimation of urinary 5-HIAA excretion would seem to be a sensible procedure in the follow-up of patients who have had a primary carcinoid tumour resected. The test may not be sensitive enough to detect small quantities of metabolites secreted by small tumours (residual, metastatic or new primary); but the finding of a rising 5-HIAA excretion in consecutive tests carried out at reasonable intervals (say, every 3 months) would be significant, and should lead to the search, localisation and, where feasible, extirpation of the tumour.