eMedicine Specialties > Oncology > Carcinomas of the Gastrointestinal Tract

Carcinoid Tumor, Intestinal: Follow-up

Author: Hemant Singhal, MD, MBBS, FRCSE, FRCS(C), Senior Lecturer, Department of Surgery, Imperial College School of Medicine, UK; Consultant Surgeon, Northwick Park and St Marks Hospitals, UK
Coauthor(s): Kanchan Kaur, MBBS, MS, MRCS (Ed), Clinical Fellow, Department of Surgery, Northwick Park Hospital, UK; Alan A Saber, MD, MS, FACS, Chief, Minimally Invasive Surgery and Bariatric Surgery, Associate Professor, Department of Surgery, Michigan State University; Charles Zammit, MD, Senior Specialist Registrar, Department of Surgery, Breast Unit Charing Cross Hospital of London, England; Michael K McLeod, MD, FACE, FACS, Professor of Surgery and Program Director, Integrated General Surgery Program, Department of Surgery, Michigan State University College of Human Medicine
Contributor Information and Disclosures

Updated: Jan 8, 2009

Follow-up

Further Outpatient Care

Surveillance of treated carcinoid patients depends on the initial stage at presentation and the type of treatment that was offered.

  • For appendicular carcinoids that are less than 2 cm and localized to the appendix, no further follow-up is required after the patients have had an appendicectomy.
  • For those patients who have had a right hemicolectomy, blood markers (5-HIAA, chromogranin A) need to be monitored at 3 months after resection along with imaging in the form of a CT scan or MRI.
  • For rectal carcinoids 2 cm or less, which have been amenable to transanal excision, follow-up is required in the form of a proctoscopy at 6 and 12 months, and further investigations are warranted only if clinically indicated.
  • For other people with intestinal carcinoid tumors, long-term monitoring is required. This involves blood markers every 6 months for the first 3 years and then yearly thereafter. Additional imaging is performed based on the results of the markers and clinical findings.13

Miscellaneous

Medicolegal Pitfalls

Because patients with carcinoid tumors present with a plethora of symptoms, diagnosis is usually delayed. This delay can be the basis of litigation.

 


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References
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Further Reading

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Keywords

intestinal carcinoid tumor, intestinal carcinoid tumour, gastroenteropancreatic neoplasm, GEP, GEP neoplasm, well-differentiated gastrointestinal neuroendocrine cancer, GI neuroendocrine tumor, neuroendocrine tumor, neuroendocrine tumour, argentaffinoma, carcinoid syndrome, small bowel malignancy, irritable bowel syndrome, IBS, idiopathic flushing, intestinal tumor, intestinal tumour, GI tumor, GI tumour, gastrointestinal tumor, gastrointestinal tumour, intestinal malignancy, appendectomy, cancer of the appendix, carcinoid tumor of the appendix, carcinoid tumor of the small intestine, distal small bowel malignancy

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Contributor Information and Disclosures

Author

Hemant Singhal, MD, MBBS, FRCSE, FRCS(C), Senior Lecturer, Department of Surgery, Imperial College School of Medicine, UK; Consultant Surgeon, Northwick Park and St Marks Hospitals, UK
Hemant Singhal, MD, MBBS, FRCSE, FRCS(C) is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada and Royal College of Surgeons of Edinburgh
Disclosure: Nothing to disclose.

Coauthor(s)

Kanchan Kaur, MBBS, MS, MRCS (Ed), Clinical Fellow, Department of Surgery, Northwick Park Hospital, UK
Disclosure: Nothing to disclose.

Alan A Saber, MD, MS, FACS, Chief, Minimally Invasive Surgery and Bariatric Surgery, Associate Professor, Department of Surgery, Michigan State University
Alan A Saber, MD, MS, FACS is a member of the following medical societies: American College of Surgeons, American Society for Gastrointestinal Endoscopy, and American Society for Metabolic and Bariatric Surgery
Disclosure: Nothing to disclose.

Charles Zammit, MD, Senior Specialist Registrar, Department of Surgery, Breast Unit Charing Cross Hospital of London, England
Disclosure: Nothing to disclose.

Michael K McLeod, MD, FACE, FACS, Professor of Surgery and Program Director, Integrated General Surgery Program, Department of Surgery, Michigan State University College of Human Medicine
Michael K McLeod, MD, FACE, FACS is a member of the following medical societies: American Association of Clinical Endocrinologists, American Association of Endocrine Surgeons, American College of Surgeons, American Medical Association, Association for Academic Surgery, Central Surgical Association, International Association of Endocrine Surgeons, Michigan State Medical Society, Midwest Surgical Association, National Medical Association, Society of American Gastrointestinal and Endoscopic Surgeons, and Western Surgical Association
Disclosure: Nothing to disclose.

Medical Editor

Lodovico Balducci, MD, Professor of Oncology and Medicine, University of South Florida College of Medicine; Division Chief, Senior Adult Oncology Program, H Lee Moffitt Cancer Center and Research Institute
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Benjamin Movsas, MD, Vice-Chairman, Department of Radiation Oncology, Fox Chase Cancer Center
Benjamin Movsas, MD is a member of the following medical societies: American College of Radiology, American Radium Society, and American Society for Therapeutic Radiology and Oncology
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD, Clinical Professor of Medicine, Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Arizona College of Medicine at Tucson; Consulting Staff, Arizona Cancer Center
Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research
Disclosure: GlobeImmune Salary Consulting; Amplimed Consulting fee Consulting; FibroGen Consulting fee Consulting

 
 
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