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. 1969 Aug;10(8):617–622. doi: 10.1136/gut.10.8.617

Massive hepatic resection for the carcinoid syndrome

R Zeegen, R Rothwell-Jackson, M Sandler
PMCID: PMC1552919  PMID: 5810970

Abstract

Removal of the right lobe of the liver which was occupied largely by metastases, together with resection of ileal primary tumours, brought about complete remission of symptoms and signs in a 43-year-old man with a six-year history of the carcinoid syndrome. Investigations should be orientated toward surgery. When practicable, radical surgery of the type described here appears to offer the best hope of alleviating the distressing clinical features of the condition.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adson M. A., Jones R. R. Hepatic lobectomy. Arch Surg. 1966 Apr;92(4):631–635. doi: 10.1001/archsurg.1966.01320220187029. [DOI] [PubMed] [Google Scholar]
  2. Bersohn I., Bleloch J. A. Right hemi-hepatectomy in secondary carcinoid of the liver--clinical course and liver-function tests. S Afr Med J. 1967 Mar 18;41(11):271–274. [PubMed] [Google Scholar]
  3. Bucher N. L. Experimental aspects of hepatic regeneration. N Engl J Med. 1967 Sep 28;277(13):686–contd. doi: 10.1056/NEJM196709282771306. [DOI] [PubMed] [Google Scholar]
  4. CHANDLER J. J., FOSTER J. H. MALIGNANT CARCINOID SYNDROME TREATED BY RESECTION OF HEPATIC METASTASES. Am J Surg. 1965 Feb;109:221–222. doi: 10.1016/s0002-9610(65)80146-5. [DOI] [PubMed] [Google Scholar]
  5. Contractor S. F., Jeacock M. K. A possible feed-back mechanism controlling the biosynthesis of 5-hydroxytryptamine. Biochem Pharmacol. 1967 Oct;16(10):1981–1987. doi: 10.1016/0006-2952(67)90309-7. [DOI] [PubMed] [Google Scholar]
  6. DUBACH U. C., GSELL O. R. Carcinoid syndrome: alleviation of diarrhoea and flushing with "Deseril" and Ro 5-1025. Br Med J. 1962 May 19;1(5289):1390–1391. doi: 10.1136/bmj.1.5289.1390. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. ELLIOTT G. B., GRACE D. A., GIBSON H. E. The serotonin syndrome in carcinoidosis. Can J Surg. 1962 Jan;5:70–75. [PubMed] [Google Scholar]
  8. Engelman K., Lovenberg W., Sjoerdsma A. Inhibition of serotonin synthesis by para-chlorophenylalanine in patients with the carcinoid syndrome. N Engl J Med. 1967 Nov 23;277(21):1103–1108. doi: 10.1056/NEJM196711232772101. [DOI] [PubMed] [Google Scholar]
  9. GUYNN V. L., REYNOLDS J. T., OVERSTREET R. J. Right hepatic lobectomy. Technical problems and patient management. Surg Clin North Am. 1963 Feb;43:63–77. doi: 10.1016/s0039-6109(16)36885-2. [DOI] [PubMed] [Google Scholar]
  10. Gailitis R. J. The malignant carcinoid syndrome. Report of 5 cases. Am J Dig Dis. 1966 Aug;11(8):630–647. doi: 10.1007/BF02233511. [DOI] [PubMed] [Google Scholar]
  11. Gardner B., Dollinger M., Silen W., Back N., O'Reilly S. Studies of the carcinoid syndrome: its relationship to serotonin, bradykinin, and histamine. Surgery. 1967 Jun;61(6):846–852. [PubMed] [Google Scholar]
  12. Grahame-Smith D. G., Peart W. S., Ferriman D. G. Carcinoid syndrome. Proc R Soc Med. 1965 Sep;58(9):701–702. doi: 10.1177/003591576505800920. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. HANSON A., SERIN F. Determination of 5-hydroxy-indole-acetic acid in urine; and its excretion in patients with malignant carcinoids. Lancet. 1955 Dec 31;269(6905):1359–1361. doi: 10.1016/s0140-6736(55)93160-3. [DOI] [PubMed] [Google Scholar]
  14. JEPSON J. B. Paper chromatography of urinary indoles. Lancet. 1955 Nov 12;269(6898):1009–1011. doi: 10.1016/s0140-6736(55)93432-2. [DOI] [PubMed] [Google Scholar]
  15. JONES W. P. Serotonin and the carcinoid syndrome. Can Anaesth Soc J. 1959 Apr;6(2):130–140. doi: 10.1007/BF03014209. [DOI] [PubMed] [Google Scholar]
  16. KAEHLER H. J., HEILMEYER L. [Clinical aspects and pathophysiology of carcinoid and carcinoid syndrome with special reference to the pharmacology of 5-hydroxytryptamine]. Ergeb Inn Med Kinderheilkd. 1961;16:292–559. [PubMed] [Google Scholar]
  17. KINLOCH J. D., WEBB J. N., ECCLESTON D., ZEITLIN J. CARCINOID SYNDROME ASSOCIATED WITH OAT-CELL CARCINOMA OF BRONCHUS. Br Med J. 1965 Jun 12;1(5449):1533–1535. doi: 10.1136/bmj.1.5449.1533. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. KIRKPATRICK C. H. Malignant carcinoid tumors. J Kans Med Soc. 1959 Dec;60:551–555. [PubMed] [Google Scholar]
  19. KRIKLER D. M., LACKNER H., SEALY M. A. Malignant argentaffinoma and the carcinoid syndrome. S Afr Med J. 1958 May 17;32(20):514–520. [PubMed] [Google Scholar]
  20. Leahy J., Moloney M. A. The carcinoid syndrome. Ir J Med Sci. 1967 Jun;6(498):269–276. doi: 10.1007/BF02953866. [DOI] [PubMed] [Google Scholar]
  21. Ludin H., Fahrländer H. J., Renggli I. Zur Darstellung von Karzinoid-Lebermetastasen mittels visceraler Arteriographie. Schweiz Med Wochenschr. 1966 Dec 10;96(49):1642–1648. [PubMed] [Google Scholar]
  22. MACDONALD R. A. A study of 356 carcinoids of the gastrointestinal tract; report of four new cases of the carcinoid syndrome. Am J Med. 1956 Dec;21(6):867–878. doi: 10.1016/0002-9343(56)90101-2. [DOI] [PubMed] [Google Scholar]
  23. MOSENTHAL W. T. RESECTION OF MASSIVE LIVER METASTASES IN THE MALIGNANT CARCINOID SYNDROME. REVIEW AND REPORT OF A CASE. Surg Clin North Am. 1963 Oct;43:1253–1262. doi: 10.1016/s0039-6109(16)37080-3. [DOI] [PubMed] [Google Scholar]
  24. Mason D. T., Melmon K. L. New understanding of the mechanism of the carcinoid flush. Ann Intern Med. 1966 Dec;65(6):1334–1339. doi: 10.7326/0003-4819-65-6-1334. [DOI] [PubMed] [Google Scholar]
  25. OGILVIE H. Partial hepatectomy; observations on an illustrative case. Br Med J. 1953 Nov 21;2(4846):1136–1138. doi: 10.1136/bmj.2.4846.1136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Oates J. A., Butler T. C. Pharmacologic and endocrine aspects of carcinoid syndrome. Adv Pharmacol. 1967;5:109–128. doi: 10.1016/s1054-3589(08)60656-0. [DOI] [PubMed] [Google Scholar]
  27. PACK G. T., ISLAMI A. H., HUBBARD J. C., BRASFIELD R. D. Regeneration of human liver after major hepatectomy. Surgery. 1962 Oct;52:617–623. [PubMed] [Google Scholar]
  28. PACK G. T., MOLANDER D. W. Metabolism before and after hepatic lobectomy for cancer. Studies in twenty-three patients. Arch Surg. 1960 Apr;80:685–692. doi: 10.1001/archsurg.1960.01290210153030. [DOI] [PubMed] [Google Scholar]
  29. SHORB P. E., Jr, MCCUNE W. S. CARCINOID TUMORS OF GASTROINTESTINAL TRACT. AN ANALYSIS OF SEVENTY CASES. Am J Surg. 1964 Feb;107:329–336. doi: 10.1016/0002-9610(64)90276-4. [DOI] [PubMed] [Google Scholar]
  30. SJOERDSMA A., OATES J. A., ZALTZMAN P., UDENFRIEND S. Serotonin synthesis in carcinoid patients. Its inhibition by alpha-methyl-dopa, with measurement of associated increases in urinary 5-hydroxytryptophan. N Engl J Med. 1960 Sep 22;263:585–588. doi: 10.1056/NEJM196009222631204. [DOI] [PubMed] [Google Scholar]
  31. STANFORD W. R., DAVIS J. E., GUNTER J. U., HOBART S. G., Jr Bronchial adenoma (carcinoid type) with solitary metastasis and associated functioning carcinoid syndrome. South Med J. 1958 Apr;51(4):449–454. doi: 10.1097/00007611-195804000-00008. [DOI] [PubMed] [Google Scholar]
  32. Sandler M., Karim S. M., Williams E. D. Prostaglandins in amine-peptide-secreting tumours. Lancet. 1968 Nov 16;2(7577):1053–1054. doi: 10.1016/s0140-6736(68)91528-6. [DOI] [PubMed] [Google Scholar]
  33. Sandler M. The role of 5-hydroxyindoles in the carcinoid syndrome. Adv Pharmacol. 1968;6(Pt B):127–142. doi: 10.1016/s1054-3589(08)60303-8. [DOI] [PubMed] [Google Scholar]
  34. THORSON A., HANSON A., PERNOW B., SODERSTROM N., WALDENSTROM J., WINBLAD S., WULFF H. B. Carcinoid tumour within an ovarian teratoma in a patient with the carcinoid syndrome (carcinoidosis); clinical picture and metabolic studies before and after total resection of tumour. Acta Med Scand. 1958 Aug 23;161(6):495–505. doi: 10.1111/j.0954-6820.1958.tb15568.x. [DOI] [PubMed] [Google Scholar]
  35. UDENFRIEND S., TITUS E., WEISSBACH H. The identification of 5-hydroxy-3-indoleacetic acid in normal urine and a method for its assay. J Biol Chem. 1955 Oct;216(2):499–505. [PubMed] [Google Scholar]
  36. URELES A. L., MURRAY M., WOLF R. Results of pharmacologic treatment in the malignant carcinoid syndrome. N Engl J Med. 1962 Aug 30;267:435–438. doi: 10.1056/NEJM196208302670904. [DOI] [PubMed] [Google Scholar]
  37. VROOM F. Q., BROWN R. E., DEMPSEY H., HILL S. R., Jr Studies on several possible antiserotonin compounds in a patient with the functioning carcinoid syndrome. Ann Intern Med. 1962 Jun;56:941–945. doi: 10.7326/0003-4819-56-6-941. [DOI] [PubMed] [Google Scholar]
  38. WILLIAMS E. D., AZZOPARDI J. G. Tumours of the lung and the carcinoid syndrome. Thorax. 1960 Mar;15:30–36. doi: 10.1136/thx.15.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. WILSON H., BUTTERICK O. D., Jr Massive liver resection for control of severe vasomotor reactions secondary to malignant carcinoid. Ann Surg. 1959 May;149(5):641–647. doi: 10.1097/00000658-195905000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. WILSON H., STORER E. H. Malignant carcinoid syndrome. Arch Surg. 1959 Dec;79:917–919. doi: 10.1001/archsurg.1959.04320120059007. [DOI] [PubMed] [Google Scholar]
  41. WILSON H., STORER E. H., STAR F. J. Carcinoid tumors. A study of seventy-eight cases. Am J Surg. 1963 Jan;105:35–39. doi: 10.1016/0002-9610(63)90265-4. [DOI] [PubMed] [Google Scholar]
  42. WILSON H. The malignant carcinoid syndrome: massive liver resection for symptomatic relief. Am Surg. 1959 Aug;25:567–570. [PubMed] [Google Scholar]

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