Management of carcinoid tumors

A series of 59 carcinoid tumors observed at the University of Texas M. D. Anderson Hospital and Tumor Institute at Houston is presented. Histologically, carcinoid tumors cannot be differentiated as being benign or malignant. They are slow growing, and surgical excision is the preferred treatment. Local excision for small (under 2 cm) lesions and more radical excisions along with the regional lymph nodes for larger lesions are indicated. Twenty-five percent of the lesions in our study developed in patients having other primary cancers. They may be multiple, as often is the case in ileal lesions. A certain number of patients develop the carcinoid syndrome with all or many of its characteristic symptoms. Chemotherapy and x-ray therapy have limited use in the management of these patients. Antiserotonin drugs and cortisone may be beneficial in the therapy of carcinoid syndrome. In our study, all patients with the syndrome died; but 3 patients died from the disease without having the syndrome. All other deaths were attributed to causes not related to the carcinoid lesions, often from coexisting malignancies.