CARCINOID TUMOR OF THE CEACUM. SIX YEARS FOLLOW-UP OF HEPATIC METASTASIS AFTER OCTROCIDE TREATMENT INITIATION. REPORT OF A CASE
Keywords:
carcinoid, hepatic metastasis, surgical treatment, somatostatine, octreotide,Abstract
Carcinoid tumors are relatively rare and most commonly localized in digestive tract. They can metastasize to liver or lung and giνe rise to carcinoid syndrome. Surgical management is the main approach to patients with carcinoid tumors and can lead to definite cure in localized small tumors-or used as a palliative treatment in metastatic disease. Among the currently available therapeutic modalities for carcinoid syndrom, long acting analogs of somatostatin as octretide and lanreotide has been shown to be the most effective. We present our experience of a patient with carcinoid tumor of the ceacum and multiple liver metastasis that subjected to right side colectomy followed with octretide treatment. During six years follow-up the primary site of tumor was free of the disease and routine CT scanning reveal reduction of the size of hepatic metastasis as a result of octreotide treatment. These findings were confirmed during laparoscopy for cholocystectomy that performed 3 years after octreotide treatment initiation.
References
Godwin JD. Carcinoid tumors. An analysis of 2837 cases. Cancer 1975;2:560-590
Sjoerdsma Α, Lovenberg W, Engelman Κ. Serotonine now; clinical implications of inhibiting its synthesis with parachlorophenylanine. Ann Intern Med 1970;73:607-620
Moertel CG. Αn odyssey in the land of small tumors. J Clin Oncol 1987;5:1503-22
Davis Ζ, Moertel CG, McIlath DC. The malignant carcinoid syndrome. Surg Gynecol Obstet 1973;137:637-644
Mani S, Modlin IM, Ballantyne G, et al. Carcinoids of the rectum. J Am Coll Surg 1994;179:231-248
Moertel CG, Weiland LH, Nagorney DM, et al. Carcinoid tumor of the appendix: treatment and prognosis. New England Journal of Medicine 1987;317:1699-1701
Martin JK, Moertel CG, Adson ΜΑ, et al. Surgical treatment of functioning metastatic carcinoid tumors. Arch Surg 1893;1189:537-542
Moertel CG. Treatment of the carcinoid tumor and the malignant carcinoid syndrome. J Clin Oncol 1983; 1:727-740
Delcore R, Friesen SR. Gastrointestinal neuroendocrine tumors. J Am Coll Surg 1994;1778:187-211
Spread C, Berkel Η, Jewell L, et al. Colon carcinoid tumors: a population-based study. Diseases of the Colon and Rectum 1994;37:482-491
Gerstle JT, Kauffman GL, Koltun W Α. The incidence, management and outcome of patients with gastrointestinal carcinoids and second primary malignancies. J Am Coll Surg 1995;180:427-432
Gorden Ρ, Comi RL, Maton PN, et al. Somatostatin and Somatostatin analogue (SMS 201-995) in treatment of hormonesecreting tumors of the pituitary and gastrointestinal tract and non-neoplastic diseases of the gut. Ann Intern Med 1989;110:35-50
Oberg Κ, Norheim I, Lind Ε, et al. Treatment of malignant carcinoid tumors with human leukocyte interferon: long-term results. Cancer Treatment Reports 1986;70:1297-1304
Moertel CG, Rubin J Kvols LK. Therapy of metastatic carcinoid tumor and the malignant carcinoid syndrome with recombinant leukocyte an interferon. J Clin Oncol 1989;7:865-868
Roggo Α, Wood WC, Ottinger LW. Carcinoid tumors of the appendix. Ann Surg 1993;217:385-390
Gouzi JL, Laigneau Ρ, Delalande JP, et al. Indications for right hemicolectomy in carcinoid tumors of the appendix. Surg Gynecol Obstet 1993;176:543-547
Diaco DS, Hajarizadeh Η, Mueller CR, et al. Treatment of metastatic carcinoid tumors using multimodality therapy of octreotide acetate, intraarterial chemotherapy, and hepatic arterial chemoembolization. Am J Surg 1995;169:523-528
Taal BG, Hoefangel CA, Valdes Olmos RA, et al. Palliative effect of metaiodobenzylguanine in metastatic carcinoid tumors. J Clin Oncol 1996;14:1829-1838
Schupak KD, Wallner ΚΕ. The role of radiation therapy in the treatment off locally unresectable or metastatic carcinoid tumors. International Journal of Radiation Oncology 1996;20:489-495
Carrasco CH, Charnsangavej C, Ajani J, et al. The carcinoid syndrome: palliation by hepatic artery embolization. Am J Roentgenol 1986;147:149-154
Moertel CG, May GR, Martin JK, et al. Sequential hepatic artery occlusion (HAO) and chemotherapy for metastatic carcinoid tumor and islet cell carcinoma (ICC). Proceedings of the American Society of Clinical Oncology 1985;4:80
Moertel CG, Johnson CM, McKusick ΜΑ, et al. The management of patients with advance carcinoid tumors and islet cell carcinomas. Ann Intern Med 1994;120:302-9
Moertel CG, Kvols LK, Rubin J. Α study of cyproheptamide in the treatment of metastatic carcinoid tumor and the malignant syndrome. Cancer 1991;67:33-36
Tiensuu Janson EM, Ahlstrom Η, Andersson Τ. Octreotide and interferon alfa: a new combination f or the treatment of malignant carcinoid tumors. European Joumal of Cancer 1992;28:1647-1650
Andreyev HJ, Scott-Mackie Ρ, Cunningham D, et al. Phase II study of continuous infusion fluorouracil and interferon alfa-2b in the palliation of malignant neuruondocrine tumors. J Clin Oncol 1995;13:1486-1492
Νίκου ΓΚ. Καρκινοειδείς όγκοι και καρκινοειδές σύνδρομο. Ιατρική 1992;62:560-63
Lamberts SW, Hofland LJ, et al. Parallel in vivo and vitro detection of functional Somatostatin receptors in human endocrine pancreatic tumors. Consequences with regard to diagnosis, localization and therapy. J Clin Endocrinol Metab 1990;71:566-74
Kouroumalis Ε, Skordilis Ρ, Thermos Κ, Vasilaki Α, Moschandrea J, Manousos ΟΝ. Treatment of hepatocelular carcinoma with octreodide: a randomized controlled study. Gut 1988; 42: 442-447
Lamberts SW, Krenning EP, Reubi JC. The role of somatostatin and its analogue in the diagnosis and treatment of tumors. Endocrine Reviews 1991;12:450-82
Erers Μ, Parekh D, Townsend CM, et al. Somatostatin and analogs in the treatment of cancer. Ann Surg 1991;213:190-198
Kvols LK, Moertel CG, Ο 'Connel MJ, et al. Treatment of the malignant carcinoid syndrome: evaluation of a long-acting somatostatin analogue. New England Journal of Medicine 1986;315:663-666
Kvols LK, Martin JK, Marsh HM, et al. Rapid reversal of carcinoid crisis with a somatostatin analogue. New England Journal of Medicine 1985;313:1229-1230
Nicou GC, Katsilambros Ν, Sficakis Ρ. Somatostatin anaJogue SMS 201-995 in the treatment of metastatic carcinoid and islet cell tumors. Digestion 1990;46:125-126
Sassolas G, Khalfallah Υ, Chayvialle JA. Effects of the somatostatin analogue BIM 23014 on the secretion of growth hormone, thyrotropin and digestive peptides in normal men. J Clin Endocrinol Metab 19889;68:239-246
Morange I, Boisvilliers F, Chanson Ρ , Dewalliny D, Catus F, et al. Slow release lanreotide treatment in acromegalic patients previously normalized by octreotide. J Clin Endocrinol Metab 1994;79:145-151
Ruszniewski Ρ, Ducreux Μ, Chayvialle JA, et al. Treatment of the carcinoid syndrome with the longacting somatostatin analogue lanreotide: a prospective study of 39 patients. Gut 1996;39:279-283
Saltz L, Trochanowski Β, Buckley Μ, Heffernan Β, Niedzwiecki D, Tao Υ, et al. Octreotide as an antineoplastic agent in the treatment of functional and non-functional neuroendocrine tumors. Cancer 1993;72:244-248
Arnold R, Neuhaus C, Benning R, Schwerk WB, Trautmann ΜΕ, Joseph Κ, et al. Somatostatin analog Santostatin and inhibition of tumor growth in patients with metastatic endocrine gastroenteropancreatic tumors. World J Surg 1993;17:511-9
