Clinical Manifestation of Small Bowel Neuroendocrine Tumors

Rodrigo Arrangoiz MS, MD, FACS, FSSO

👉Most small bowel carcinoid tumors are asymptomatic and are discovered incidentally.

  • When present, symptoms are often vague and chronic, including:
    • Abdominal pain
    • Obstructive symptoms
    • Weight loss
    • Fatigue
    • Bleeding / anemia
  • Patients with small bowel carcinoids can also present with regional or distant metastases without an obvious primary tumor:
    • Most commonly manifested as a:
      • Mesenteric mass or liver metastases without an obvious small bowel tumor
  • Most small bowel carcinoid tumors:
    • Secrete biologically active amines:
      • But functional hormone syndromes:
        • As seen in pancreatic neuroendocrine tumors:
          • Are rare in small bowel carcinoid tumors
    • However:
      • Patients with metastatic disease:
        • Can present with carcinoid syndrome:
          • Secretory diarrhea (80%)
          • Cutaneous flushing (60% to 85%)
          • Right heart disease (20%)
          • Wheezing and dyspnea (10% to 20%)
        • Classically, patients with carcinoid syndrome:
          • Have hepatic metastases:
            • Which bypass hepatic clearance:
              • Of serotonin
  • Small bowel carcinoids:
    • Most frequently arise in the terminal ileum:
      • Often within 60 cm of the ileocecal valve

#Arrangoiz #SurgicalOncologist #CancerSurgeon #Teacher #Surgeon #SmallBowelCancer

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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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