Resection of Massive Liver Metastases in the Malignant Carcinoid Syndrome: Review and Report of a Case

A Carcinoid Saga

“…In addition, reduction of 5HT synthesis by (kcarboxylase inhibitors has not correlated well with improvement in flushing, and it appears likely that the kinin precursor kallikrein is the commonest cause of Bushing in the svndrnnie resection for the carcinoid syndrome is instructive, as most cases follow the same pattern (Mengel, 1965 ;Mosenthal, 1963 ;Reiss, 1968 ;Sokoloff, 1968 ;Wilson, 1959aWilson, , 1959bWilson et alii, 1963). Wilson (I959a) reported the case of a patient who had been studied extensively radiologically for ahdominal pain and diarrhea without achievement of any definitive diagnosis.…”

“…It is difficult, of course, to assess the effect of treatment on a disease which often progresses so slowly that patients with known hepatic metastases from carcinoid tuinour have lived for up to five years without any apparent increase in their symptoms (Mosenthal, 1963).…”

“…( 3 ) Anasthesin for rcsecfion.-The adiminstration of anzsthetcs to patients with the carcinoitl syndrome may he quite uneventful, hut occasionally a disquietinc; syndrome of vascnlar collapse and hronchoconstriction occurs (Mosenthal, 1963). Hypotension and norxdrenalin release are potent stimuli for jHT release.…”

“…HEPATIC resection for secondary carcinoma rarely results in useful palliation of the disease. However, several recent reports have emphasized that this is not so when the patient has hepatic metastases producing the carcinoid syndrome (Chandler and Foster, 1965 ;Mosenthal, 1963 ;Reiss, 1968 ;Wilson, 1959a, I959b ;Wilson and Butterick, 19 j9). Although most authors suggest that surgery produces worth-while symptomatic relief by removing 3 large quantity of functioning carcinoid tissue, there are few well-documented reports in the Reprints : M r Cameron Battersby, University of Queensland Department of Surgery, Clinical Sciences Building, Royal Brisbane Hospital, Brisbane, Qld,…”

Massive hepatic resection for the carcinoid syndrome

“…At present, medical treatment is of limited value. Removal of as much secreting tissue as possible is the most rational approach and palliative resection of hepatic metastases has been carried out in a small number of cases with encouraging results (Stanford, Davis, Gunter, and Hobart, 1958;Wilson and Butterick, 1959;Crile, 1959;Williams and Azzopardi, 1960;Mosenthal, 1963;Shorb and McCune, 1964;Chandler and Foster, 1965;Adson and Jones, 1966;Ludin, Fahrlander, and Renggli, 1966;Bersohn and Bleloch, 1967;Gardner, Dollinger, Silen, Back, and O'Reilly, 1967;Leahy and Moloney, 1967). We now report a further case, where there was complete relief of symptoms following resection of primary lesions in the ileum and massive hepatic metastases.…”