A NEW INCOME IN PEDIATRIC PATHOLOGY: GASTROENTEROPANCREATIC NEUROENDOCRINE TUMORS. II: CARCINOID TUMORS

Authors: Smaranda Diaconescu, M. Burlea, Claudia Olaru, Nicoleta Gimiga, Ileana Ioniuc, Iulia STRATICIUC‑CIONGRADI, Doina MIHAILA, Ingrith MIRON

Abstract:

Carcinoid tumors are classified according to theirembryologic origin, that might be the foregut (stomach, duodenum, biliary tree and also lung, thymus, thyroid), the midgut (ileum, right colon) and the hindgut (left colon and rectum). The clinical picture of these lesions is variable, evidencing completely asymptomatic cases, symptoms due to complications (acute appendicitis, peritonitis, obstructions or hemorrhages) or sudden apparition of carcinoid syndromes. The diagnosis includes urinary 5 HIAA, chromogranine A dosage and Ki‑67 expression, as well as localising studies, such as echoendoscopy, videocapsule and enteroscopy, CT, MRI, selective abdominal angiography, somatostatin‑receptor‑scintigraphy (Octreoscan, SRI). Coronal contrast‑enhanced CT or MRI angiogram
can evaluate the mesenteric vessels spread before surgery. Upper endoscopy or/and colonoscopy can be performed to detect foregut or hindgut lesions. The treatment is based on surgery and other removal techniques, such as cryoablation and radiofrequency ablation, traditional drugs: streptozocin, 5‑fluorouracyl, doxorubicin, cyclophos phamide, mitomicycin, metrotrexate together with somatostatin analogs; the future belongs to radionuclide‑radiopeptide therapy.