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Vol 60, No 5 (2009)
Case report
Submitted: 2013-02-15
Published online: 2009-10-30
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Long-term survival and nearly asymptomatic course of carcinoid tumour with multiple metastases (treated by surgery, chemotherapy, 90Y-DOTATATE, and LAR octreotide analogue): a case report

Marcin Kałużny, Marek Bolanowski, Małgorzata Sukiennik-Kujawa, Piotr Ponikowski, Daria Handkiewicz-Junak, Barbara Jarząb, Aleksandra Jawiarczyk, Joanna Syrycka
Endokrynol Pol 2009;60(5):401-406.

open access

Vol 60, No 5 (2009)
Case report
Submitted: 2013-02-15
Published online: 2009-10-30

Abstract

Carcinoids are the most common neuroendocrine tumours. They are usually slowly growing, located in the small intestine, secrete serotonin, and are characterized by long survival of patients, so prognosis is generally good. The most frequently encountered clinical presentations of carcinoids are intermittent abdominal pain and carcinoid syndrome (diarrhoea and flushing). Metastases worsen the prognosis and limit the survival of the patients. We report a case of carcinoid tumour with primary focus in the ileum, with an appendix infiltration, in a thirty-two-year-old woman with acute appendicitis symptoms only. Carcinoid was diagnosed postoperatively by histopathological examination. Nowadays, twenty-five years after the surgery, there is evidence of nearly asymptomatic numerous metastases. Only intermittent abdominal pain for about 1-2 years was reported. Partial metastases resection was performed, followed by chemotherapy, 90Y-DOTATATE and then long-acting release octreotide analogue therapy. In the meantime, severe chronic heart failure (NYHA IV) due to tricuspid combined valvular heart disease and pulmonary hypertension was diagnosed. Combined therapy, typical for chronic heart failure, together with long-acting octreotide analogue highly improved the patient’s heart sufficiency and reduced carcinoid syndrome symptoms. The only adverse events of octreotide therapy were hyperbilirubinaemia and itching. Long-term survival is typical for carcinoids, but 30-years survival has not been described in the literature yet.

Abstract

Carcinoids are the most common neuroendocrine tumours. They are usually slowly growing, located in the small intestine, secrete serotonin, and are characterized by long survival of patients, so prognosis is generally good. The most frequently encountered clinical presentations of carcinoids are intermittent abdominal pain and carcinoid syndrome (diarrhoea and flushing). Metastases worsen the prognosis and limit the survival of the patients. We report a case of carcinoid tumour with primary focus in the ileum, with an appendix infiltration, in a thirty-two-year-old woman with acute appendicitis symptoms only. Carcinoid was diagnosed postoperatively by histopathological examination. Nowadays, twenty-five years after the surgery, there is evidence of nearly asymptomatic numerous metastases. Only intermittent abdominal pain for about 1-2 years was reported. Partial metastases resection was performed, followed by chemotherapy, 90Y-DOTATATE and then long-acting release octreotide analogue therapy. In the meantime, severe chronic heart failure (NYHA IV) due to tricuspid combined valvular heart disease and pulmonary hypertension was diagnosed. Combined therapy, typical for chronic heart failure, together with long-acting octreotide analogue highly improved the patient’s heart sufficiency and reduced carcinoid syndrome symptoms. The only adverse events of octreotide therapy were hyperbilirubinaemia and itching. Long-term survival is typical for carcinoids, but 30-years survival has not been described in the literature yet.

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Keywords

carcinoid; octreotide; chronic heart failure

About this article
Title

Long-term survival and nearly asymptomatic course of carcinoid tumour with multiple metastases (treated by surgery, chemotherapy, 90Y-DOTATATE, and LAR octreotide analogue): a case report

Journal

Endokrynologia Polska

Issue

Vol 60, No 5 (2009)

Article type

Case report

Pages

401-406

Published online

2009-10-30

Page views

664

Article views/downloads

1619

Bibliographic record

Endokrynol Pol 2009;60(5):401-406.

Keywords

carcinoid
octreotide
chronic heart failure

Authors

Marcin Kałużny
Marek Bolanowski
Małgorzata Sukiennik-Kujawa
Piotr Ponikowski
Daria Handkiewicz-Junak
Barbara Jarząb
Aleksandra Jawiarczyk
Joanna Syrycka

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