16 November 2009
Carcinoid heart disease as a first manifestation of midgut carcinoid tumor in a young woman
Andrzej Tomaszewski, Beata Matuszek, Tomasz Zapolski, Elżbieta Czekajska-Chehab, Mariusz Matuszek, Sławomir RudzkiAm J Case Rep 2009; 10:193-197 :: ID: 878251
Abstract
Background: The most common neuroendocrine tumor (NET) of the gastroenteropancreatic axis is a midgut carcinoid tumor producing serotonin, which is characterized by slow growth but high malignancy potential. The tumor is commonly asymptomatic until it becomes large or has metastasized. Up to 10% of the patients develop carcinoid syndrome due to the release of tumor secretions into the systemic circulation, avoiding the portal circulation. Clinically, this is characterized by hot flushes, diarrhea, bronchospasm, and carcinoid heart disease at diagnosis in approximately 50% of the patients with carcinoid syndrome, but only in 10‑20% is this the first clinical symptom of the syndrome.
Case Report: The case of a 34-year-old woman with carcinoid heart disease in the course of carcinoid syndrome as the first clinical symptom of midgut carcinoid tumor is presented. This unusual course of the clinical picture significantly prolonged and hindered the diagnostic process. However, extensive surgical, cardiologic, and endocrinological treatment was successful. One-year, two-year, and five-year follow-ups showed improved heart function and no signs of tumor relapse.
Conclusions: Even though heart disease coexists with other symptoms typical of carcinoid syndrome, it should be borne in mind that right-sided heart failure could be the first sign of the disease. Echocardiography is the investigation of choice, revealing a unique valvular appearance at diagnosis, and should be performed at the time of diagnosing serotonin-producing NET. Multidisciplinary management (surgical and medical) could improve prognosis and the quality of life of the patients.
Keywords: midgut carcinoid tumor, Carcinoid Heart Disease, valvular dysfunction
In Press
19 Mar 2024 : Case report
Bilateral Simultaneous Basal Ganglia Hemorrhage: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.943174
19 Mar 2024 : Case report
Medial Hoffa Fracture: A Case Report and Literature Review of Approach and ManagementAm J Case Rep In Press; DOI: 10.12659/AJCR.943136
21 Mar 2024 : Case report
Pediatric Neurogenic Pulmonary Edema After Brain Tumor Removal Complicated with Severe Myocardial Injury: A...Am J Case Rep In Press; DOI: 10.12659/AJCR.943645
21 Mar 2024 : Case report
Chlamydia psittaci Pneumonia: Diagnosis, Treatment, and Challenges in the Context of COVID-19Am J Case Rep In Press; DOI: 10.12659/AJCR.942921
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250