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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Azienda Istituti Ospitalieri - Cremona, Divisione Dermatologica
The term carcinoid syndrome has been used to describe the humoral manifestation of carcinoid tumors: flushing, bronchoconstriction, gastrointestinal hypermotility and cardiac disease. These symptoms are determined by hypersecretion of serotonin, other biogenic amines (histamine and dopamine) and tachykinins (kallikrein, substance-P, neurokinin-A and neuropeptide-K). We point out that searching for flushing should’nt be neglected because an early diagnosis is mandatory for patient survival. We report a case of a forty-one year old male sent to our observation as an outpatient for rosacea and erythema on covered skin; he also presented, for over one year, bronchobstructive episodes. The cutaneous manifestation led to a suspicion of carcinoid syndrome and carcinoid tumor was diagnosed on the basis of a raised level of urinary 5-hydroxyindolacetic acid. Liver ultrasonography and octreo-scan demonstrated multiple liver metastasis. A laparatomy identified carcinoid tumor in the ileum. Treatment combined surgical excision of the tumor, chemoembolization of the hepatic artery with doxorubicin and lipiodol and a long term treatment with octreotide and alfa-interferon. The prognosis associated with these tumors varies with the extent of metastases evident at the time of the diagnosis. An early diagnosis is mandatory for patient survival.