文献简介

出版社:

作  者:S. Datta et al

编  号:

关键字:carcinoid tumour, malignant carcinoid syndrome, carcinoma, neuroendocrine, elderly

年  份:   点击量:609

文献摘要

Abstract

An 80-year-old male patient presented with abdominal pain, paroxysmal diaphoresis, diarrhoea and vomiting. CT scan revealed a small bowel endocrine carcinoma (or ‘carcinoid’ tumour), but the absence of hepatic disease. The lesion was excised ‘en-bloc’. Intra-operatively, there was wide fluctuation in blood pressure associated with tumour manipulation, with hyper- and hypotension. Carcinoid syndrome usually occurs from gastrointestinal tumours when hepatic metastases occur, causing flushing, diarrhoea, bronchoconstriction and murmurs from cardiac valvular lesions. This patient did not have radiological evidence of hepatic metastasis, but the syndrome could still occur with midgut tumours via local invasion of the retroperitoneal circulation, or by action of substances other than serotonin that do not undergo hepatic metabolism.

摘要

一个80岁男性患者出现腹痛、阵发性出汗、腹泻和呕吐症状,CT扫描显示为小肠内分泌癌(或类癌的肿瘤),但是该患者没有肝脏疾病。手术将病变部位整块切除,在肿瘤的切除手术中,病人的血压波动很大,出现严重的低血压。类癌综合征通常在胃肠道肿瘤肝转移时发生,引起皮肤潮红、腹泻、支气管收缩和心脏瓣膜病变杂音。该患者没有肝转移的影像学证据,但类癌综合征仍然通过肠肿瘤的局部侵袭腹膜后发生,或是由血清以外,不经过肝脏代谢的物质发生作用。