This week's artwork was donated by Lonny, a pediatric cancer patient who received treatment at The Children's Hospital of Philadelphia . September 1997 Table of Contents Carcinoid tumours. Malignant carcinoid tumor and synchronous malignant extraadrenal paraganglioloma. Effectiveness of local endoscopic resection of rectal carcinoid tumors. Endosonography-guided endoscopic resection of duodenal carcinoid tumor.
Carcinoid tumours offer a diagnostic and therapeutic challenge.
Although new biochemical markers and improved methods for tumour detection, including PET and somatostatin receptor scintigraphy, have been developed during the last two decades many patients are still diagnosed at late stages of the disease. This is supported by the fact that the age of diagnosis is about the same today as it was 10 years ago. It is our opinion that plasma chromogranin A levels should be be determined in all patients which are investigated because of symptoms that might be connected to a neuroendocrine tumour. For the localization procedure conventional radiological techniques including CT, MRI and ultrasound investigations should be supplemented with somatostatin receptor scintigraphy. Endoscopic ultrasound investigations might in the future be relevant for diagnosis of duodenal carcinoids, whereas gastric and rectal carcinoids are diagnosed by endoscopy.