Successful treatment of carcinoid syndrome in two cases of bronchial carcinoid

Abstract

We encountered two patients with typical bronchial carcinoid and metastases to the liver who presented with typical carcinoid syndrome. In typical bronchial carcinoid without metastases to regional lymph nodes, recurrence and distant metastasis after curative resection are generally thought to be rare. The first patient was a 62-year-old woman who was admitted to our hospital because of facial flushing and diarrhea. She had undergone curative resection of a typical bronchial carcinoid 9 years earlier, and the postsurgical pathological stage was I. On the second admission, she was found to have multiple liver metastases. The second patient was a 59-year-old woman who was admitted to our hospital because of facial flushing, dyspnea, and dehydration due to diarrhea. She had undergone curative resection of a typical bronchial carcinoid 21 months earlier, and the postsurgical pathological stage was I. On the second admission, she was found to have multiple intrabronchial, bone, and liver metastases. Both patients were treated with subcutaneous injections of octreotide, and with transhepatic arterial chemoembolization. In addition, the second patient underwent percutaneous ethanol injection under ultrasonic guidance. Signs and symptoms disappeared soon after therapy began and the patients survived longer than expected. Hepatic artery chemoembolization and simultaneous chemotherapy can relieve symptoms in patients with carcinoid syndrome and multiple liver metastases, and self-administration of octreotide is the treatment of choice for immediate relief.