A Case Series of Carcinoid Syndrome: A Single-Centre Experience
https://doi.org/10.15605/jafes.041.S1
- Author:
Jie En Tan
1
;
Noor Ashikin Ismai
1
Author Information
1. Endocrine Institute, Hospital Putrajaya
- Publication Type:Journal Article
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):81-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Carcinoid syndrome is a hormonal complication accompanying neuroendocrine tumors (NETs) and is defined
by chronic diarrhea and/or flushing in the presence of
systemically elevated levels of serotonin or its metabolite
5-hydroxyindolacetic acid. The condition is often diagnosed
late because of nonspecific symptoms, and many patients
present with metastatic disease. This was a retrospective
review of patients with carcinoid syndrome who were followed up at the Endocrine Clinic, Putrajaya Hospital,
up to date.
Case:Three women aged between 30 and 40 years were diagnosed
with carcinoid syndrome secondary to metastatic NETs.
Two cases were diagnosed before and during their
pregnancies, resulting in one successful pregnancy while
another required termination of pregnancy. All patients
presented with symptomatic disease, predominantly
flushing and chronic diarrhea and abdominal distension,
leading to the diagnosis within the same year to as long
as a decade after symptomatology. All were found to have
extensive liver and nodal metastases at diagnosis. Liver
biopsy showed tumor grade 1 in two of the cases, while the
case with tumor grade 2 exhibited an aggressive disease
course with carcinoid heart disease and bone metastases.
None were amenable to surgery. Somatostatin analogues
(SSAs) were the mainstay of treatment, administered every
2–4 weeks and titrated according to clinical response.
Cytotoxic chemotherapy and bone-targeted agent were
given for the case with rapid disease progression and
skeletal-related event. Somatostatin analogue radiolabeled
peptide therapy (PRRT) was reserved for symptom control
in progressive disease refractory to first-line SSAs, after
assessment with PET-Ga68 DOTATATE imaging.
Conclusion:This case series highlights delayed diagnosis and advanced
presentation due to its nonspecific symptoms. The occurrence in young women, including during pregnancy,
underscores the complexity of management and the need
for individualized multidisciplinary care, with somatostatin
analogues, systemic therapy, and PRRT playing key roles
in symptoms control and disease progression.
- Full text:2026080413494958793EP_A112.pdf
