Abstract:
Carcinoid crisis (CC) has classically been considered the extreme end of the spectrum of carcinoid syndrome (CS). However, this presumption and other aspects of CC remain poorly understood. Consequently, current clinical guidelines are based on a low quality of evidence. There is no standard definition of CC and its incidence is unknown. Patients with florid CS and elevated serotonin (or its derivatives) which develop CC have been reported during decades. Nevertheless, the hypothesis that CC is due to the sudden massive release of serotonin or other vasoactive substances is unproven. Many triggers of CC (surgery, anaesthesia, peptide receptor radionuclide therapy, tumour biopsy or liver-directed treatments) have been proposed. However, data from studies are heterogeneous and even contradictory. Finally, the role of octreotide in the prevention of CC has been questioned. Herein, we report a clinical case and perform a critical review of the evidence available today on this topic.
摘要:
类癌危象(CC)通常被认为是类癌综合征(CS)的极端。然而,这一推定和CC的其他方面仍然知之甚少。因此,目前的临床指南是基于低质量的证据.CC没有标准定义,其发病率未知。数十年来,已经报道了患有花语CS和5-羟色胺(或其衍生物)升高的患者发展为CC。然而,CC是由于5-羟色胺或其他血管活性物质的突然大量释放引起的假设尚未得到证实。CC(手术,麻醉,肽受体放射性核素治疗,肿瘤活检或肝脏定向治疗)已被提出。然而,来自研究的数据是异质的,甚至是矛盾的。最后,奥曲肽在预防CC中的作用受到质疑。在这里,我们报告了1例临床病例,并对目前有关该主题的现有证据进行了严格审查.