Hemodynamic changes during “flush” in carcinoidosis

A Metastasizing Carcinoid Tumour with Unusual Features

“…Occasionally, however, malabsorption of both these substances occurs in pure pancreatic steatorrhoea (McIntyre et al, 1956;Chanarin et al, 1958). It is now believed that 5-hydroxytryptamine is chiefly destroyed in the liver (Thorson, 1956;McKusick, 1956), hence the importance of hepatic metastases in the pathogenesis of the flushing syndrome, for when this substance is produced in the liver it will escape destruction and reach the systemic circulation in high concentrations. In support of this hypothesis Thorson (1958) found that in 40 cases of metastasizing carcinoid tumours without the flushing syndrome all the deposits were drained by the portal system, whereas at least 11 out of 12 cases with flushing had deposits in the liver, ovary, or abdominal wall, which drained direct to the inferior vena cava without passing through the liver parenchyma.…”

“…It is now believed that 5-hydroxytryptamine is chiefly destroyed in the liver (Thorson, 1956;McKusick, 1956), hence the importance of hepatic metastases in the pathogenesis of the flushing syndrome, for when this substance is produced in the liver it will escape destruction and reach the systemic circulation in high concentrations. In support of this hypothesis Thorson (1958) found that in 40 cases of metastasizing carcinoid tumours without the flushing syndrome all the deposits were drained by the portal system, whereas at least 11 out of 12 cases with flushing had deposits in the liver, ovary, or abdominal wall, which drained direct to the inferior vena cava without passing through the liver parenchyma. Not only were there no signs of the carcinoid syndrome but there was also no biochemical evidence of increased 5-hydroxytryptamine formation such as an increased excretion of 5-hydroxyindole acetic acid-its principal breakdown product-in the urine.…”

Herzläsionen bei Carcinoidsyndrom und Endomyokardfibrose

“…Das durch Serotonin freigesetzte Histamin erzeugt in der Lunge des Carcinoidpatienten eine Vasokonstriktion der pulmonalen Arteriolen, wodurch das rechte Herz und dessen Klappengewebe be lastet wird (41, 53,56,57 (3, 7, 11,20bis, 28, 37, 46, 58).…”

The measurement of intestinal sounds in man and their relationship to serum 5-hydroxytryptamine

“…In patients with carcinoid tumours, a flush comparable to that produced by intravenous 5-HT can be precipitated by a variety of stimuli. Thorson (1956) lists emotion, 246 spices, and food; Snow, Lennard-Jones, Curzon, and Stacey (1955) record alcohol as a precipitant, and Bleehen (1955) reported a patient in whom a fatty meal caused flushing. Thorson (1956) produced a flush by giving a small meal after a fast, and Daugherty, Manger, Roth, Flock, Childs, and Waugh (1955) produced flushing by palpation of the tumour and by injection of histamine and adrenalin.…”

“…Thorson (1956) lists emotion, 246 spices, and food; Snow, Lennard-Jones, Curzon, and Stacey (1955) record alcohol as a precipitant, and Bleehen (1955) reported a patient in whom a fatty meal caused flushing. Thorson (1956) produced a flush by giving a small meal after a fast, and Daugherty, Manger, Roth, Flock, Childs, and Waugh (1955) produced flushing by palpation of the tumour and by injection of histamine and adrenalin. Little is known about the eflect of these stimuli on the liberation of 5-HT in the normal subject and its precise role in the alimentary tract is still not established.…”