The Carcinoid Syndrome

THE first description of a carcinoid tumour was as early as 1888 (Lubarsch). Later attention was drawn to the possibility that the cells of these tumours (known as argentaffinomas) act as secretors of some "endocrine" substance. "Enteramine" or "serotonin" (5 hydroxytryptamine or 5 H.T.) was later isolated from carcinoid tumours and recently its degradation product-5 hydroxy-indoleacetic acid or 5 H.I.A.A.-has been isolated from the urine in cases of carcinoid tumours. Carcinoid tumours have been reported in any part of the alimentary tract from the cardia to the ano-rectal junction, the gall bladder, the lungs and in ovarian and testicular teratoids (Thorson). These tumours when associated with the clinical syndrome of vasomotor, gastro-intestinal, cardiopulmonary and nutritional disturbances have been reported chiefly in cases where there were marked hepatic secondary deposits. Carcinoid tumours commonly found in the appendix do not usually metastasize nor give rise to the clinical syndrome. The clinical syndrome has been described in cases of bronchial carcinoid without hepatic metastases (Jackson and Konzelmann, 1937). At least three cases of carcinoid tumour associated with the clinical syndrome have been reported in Ulster (Fraser, 1955; Bridges et al., 1957; Nelson, 1957). A fourth case was seen in December, 1960.