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Revista Mexicana de Anestesiología

ISSN 3061-8142 (Electronic)
ISSN 0484-7903 (Print)
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2019, Number 2

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Rev Mex Anest 2019; 42 (2)

Anesthetic management of carcinoid syndrome: is octreotide enough? A case report

Rebêlo I, Maurício S, Coelho D, Gaspar A
Full text How to cite this article

Language: English
References: 4
Page: 133-136
PDF size: 134.86 Kb.


Key words:

Carcinoid syndrome, neuroendrocrine tumor, anaesthetic management, hemodynamic instability, octreotide.

ABSTRACT

Carcinoid tumors are rare slow-growing neuroendocrine tissue neoplasms. Their ability to secrete bioactive substances to the systemic circulation is accountable for a clinical presentation known as carcinoid syndrome. Main symptoms include bronchoconstriction, flushing, diarrhea and hemodynamic instability. Octreotide, a somatostatin analogue, is the current mainstay for carcinoid syndrome treatment and perioperative management. However, no regimen has proven to be completely effective in preventing systemic manifestations and recent literature suggests that it might be an insufficient measure. We report a case of a 51-year-old male with a functioning small bowel neuroendocrine tumor and carcinoid syndrome presenting for a primary tumor resection, discussing possible pitfalls and key points in the care of these patients.


REFERENCES

  1. Dierdorf SF. Carcinoid tumor and carcinoid syndrome. Curr Opin Anaesthesiol. 2003;16:343-347.

  2. Mancuso K, Kaye AD, Boudreaux JP, Fox CJ, Lang P, Kalarickal PL, et al. Carcinoid syndrome and perioperative anesthetic considerations. J Clin Anesth. 2011;23:329-341.

  3. Kaltsas G, Caplin M, Davies P, Ferone D, Garcia-Carbonero R, Grozinsky-Glasberg S, et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: pre- and perioperative therapy in patients with neuroendocrine tumors. Neuroendocrinology. 2017;105:245-254.

  4. Borna RM, Jahr JS, Kmiecik S, Mancuso KF, Kaye AD. Pharmacology of octreotide: clinical implications for anesthesiologists and associated risks. Anesthesiol Clin. 2017;35:327-339.




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Rev Mex Anest. 2019;42