Episodic flushing and diarrhoea are the most common initial symptoms. Metastatic disease may require no treatment for months or even years in the patient whose symptoms are not seriously interfering with quality of life and if the tumour is not exhibiting a biologically aggressive growth pattern. P TI - Clinical aspects of carcinoid tumours. The combination of symptoms, humoral markers and imaging techniques provide an optimal means for the identification of carcinoid tumours and their metastases. Individualized surgical treatment of these tumour types is discussed.
Liver metastases imply a major problem in patients with carcinoid tumours.
Patients with distant metastases can undergo resection for potential cure, or for symptom palliation, due to the slow growth rate of many carcinoid tumours. Patients with the foregut carcinoid syndrome may present special problems with life-threatening release of histamine during interventional treatment. In recent years, new long-acting formulations have been developed from the native peptide. Their pathogenesis depends on the combined action of promoting agents, mostly hypergastrinaemia, and of transforming agents, the role of which is currently under investigation. Their prognosis is generally favourable.