Vol 60, No 5 (2009)
Case report
Published online: 2009-10-30
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
Endokrynol Pol 2009;60(5):401-406.
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.
Keywords: carcinoidoctreotidechronic heart failure
