Clinical symptoms of carcinoid

In this section we will examine the clinical features of cases of carcinoid without metastasis, i.e. without carcinoid syndrome.
Carcinoid Appendix. Clinical signs of carcinoid process is virtually indistinguishable from those with acute or sub-acute appendicitis (M. I. Brusilovsky, 1965). Patients complain of constant periodically growing pains in the right iliac region, sometimes vomiting. Objective examination is defined by the pain in the right iliac region, often local, some patients diffuse character during the cecum. There are usually mild symptoms of peritoneal irritation. Pathognomonic symptoms not, and therefore in such cases are usually diagnosed with acute appendicitis and the patient is exposed to laparotomy. It should be emphasized that microscopic examination of the remote process is often not morphological signs of inflammation. We have already mentioned that carcinoid Appendix in most cases not more likely to spread. Perhaps this is to some extent depends on early surgical intervention in this tumor localization. In patients with metastatic tumors (mostly in the liver) develops the typical carcinoid syndrome. While the proliferation of tumor tissue capture the muscular layer, lymphatic and blood vessels (Markograf and Dunn, 1964).
Carcinoid small intestine. Leading complaint of patients with carcinoid ileum are complaints on pain lower right abdomen, which are often cramping nature, combined with flatulence, rumbling. Less commonly, there are constant pain the same type. Further relapse of pain, gradually progressing manifestations partial intestinal obstruction. Patients become dinamichnyj, lose weight, appear excessive vomiting. Objective examination are determined by the well-known signs of intestinal obstruction. According to Thorson (1958), carcinoid ileum rarely observed melaena and positive reaction of yens Gregersen collection. Often have diarrhea. In these patients, no significant changes in the peripheral blood, urine. Moertel (1961) indicates that the diagnosis in such cases is installed later, on average, not earlier than 4 years after the first symptoms of the disease.
Carcinoid stomach. Davies (1959) believes that 2-3% of all carcinoids is located in the stomach. The most common complaint of a patient in such cases are a pain in the area epigastralna, often simulating peptic ulcer disease. Along with the pain, almost always, vomiting and weight loss. Signs of gastrointestinal bleeding is rare. N. N. Markov and collaborators observed carcinoid stomach and gastric bleeding in combination with weight loss and anemia. Diagnosis meets considerable difficulties, as the disease can be asymptomatic. X-ray picture little characteristic, the tumor may look like a limited polypoid filling defect or as superficial ulcers. Carcinoids can reside in any part of the stomach. Patients with carcinoid stomach can live from 10 to 18 years.
Carcinoid duodenum is rare accidental discovery. Avulo (1968) described a patient whose carcinoid combined with lung cancer and stomach. Tumor metastasis was found.
Carcinoid rectum. According to Peskin and Orloff (1959), 1/3 of patients with carcinoid rectum, no complaints, and the diagnosis was established only when rectoskopia study. In other cases met a variety of complaints: pain when urinating, constipation, blood in the stool, etc. the most common symptoms for tumors of the rectum are intestinal bleeding and abdominal pain.
Carcinoids larger than 2 cm, germinating in the muscular layer, often accompanied by metastasis to other organs and prognostically little fit (B. N. Petrov and A. P. Tedeev, 1968). Tumors of the localization can long be asymptomatic.