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Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency

SIMPLE SUMMARY: In this review, the Authors are going to discuss the main highlights of the Carcinoid Crisis, an uncommon manifestation related to neuroendocrine tumors, focusing on the potential etiopathogenetic mechanisms, clinical implications, potential treatments and prophylaxis. ABSTRACT: Carc...

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Autores principales: Bardasi, Camilla, Benatti, Stefania, Luppi, Gabriele, Garajovà, Ingrid, Piacentini, Federico, Dominici, Massimo, Gelsomino, Fabio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833591/
https://www.ncbi.nlm.nih.gov/pubmed/35158931
http://dx.doi.org/10.3390/cancers14030662
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author Bardasi, Camilla
Benatti, Stefania
Luppi, Gabriele
Garajovà, Ingrid
Piacentini, Federico
Dominici, Massimo
Gelsomino, Fabio
author_facet Bardasi, Camilla
Benatti, Stefania
Luppi, Gabriele
Garajovà, Ingrid
Piacentini, Federico
Dominici, Massimo
Gelsomino, Fabio
author_sort Bardasi, Camilla
collection PubMed
description SIMPLE SUMMARY: In this review, the Authors are going to discuss the main highlights of the Carcinoid Crisis, an uncommon manifestation related to neuroendocrine tumors, focusing on the potential etiopathogenetic mechanisms, clinical implications, potential treatments and prophylaxis. ABSTRACT: Carcinoid Crisis represents a rare and extremely dangerous manifestation that can occur in patients with Neuroendocrine Tumors (NETs). It is characterized by a sudden onset of hemodynamic instability, sometimes associated with the classical symptoms of carcinoid syndrome, such as bronchospasm and flushing. Carcinoid Crisis seems to be caused by a massive release of vasoactive substances, typically produced by neuroendocrine cells, and can emerge after abdominal procedures, but also spontaneously in rare instances. To date, there are no empirically derived guidelines for the management of this cancer-related medical emergency, and the available evidence essentially comes from single-case reports or dated small retrospective series. A transfer to the Intensive Care Unit may be necessary during the acute setting, when the severe hypotension becomes unresponsive to standard practices, such as volemic filling and the infusion of vasopressor therapy. The only effective strategy is represented by prevention. The administration of octreotide, anxiolytic and antihistaminic agents represents the current treatment approach to avoid hormone release and prevent major complications. However, no standard protocols are available, resulting in great variability in terms of schedules, doses, ways of administration and timing of prophylactic treatments.
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spelling pubmed-88335912022-02-12 Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency Bardasi, Camilla Benatti, Stefania Luppi, Gabriele Garajovà, Ingrid Piacentini, Federico Dominici, Massimo Gelsomino, Fabio Cancers (Basel) Review SIMPLE SUMMARY: In this review, the Authors are going to discuss the main highlights of the Carcinoid Crisis, an uncommon manifestation related to neuroendocrine tumors, focusing on the potential etiopathogenetic mechanisms, clinical implications, potential treatments and prophylaxis. ABSTRACT: Carcinoid Crisis represents a rare and extremely dangerous manifestation that can occur in patients with Neuroendocrine Tumors (NETs). It is characterized by a sudden onset of hemodynamic instability, sometimes associated with the classical symptoms of carcinoid syndrome, such as bronchospasm and flushing. Carcinoid Crisis seems to be caused by a massive release of vasoactive substances, typically produced by neuroendocrine cells, and can emerge after abdominal procedures, but also spontaneously in rare instances. To date, there are no empirically derived guidelines for the management of this cancer-related medical emergency, and the available evidence essentially comes from single-case reports or dated small retrospective series. A transfer to the Intensive Care Unit may be necessary during the acute setting, when the severe hypotension becomes unresponsive to standard practices, such as volemic filling and the infusion of vasopressor therapy. The only effective strategy is represented by prevention. The administration of octreotide, anxiolytic and antihistaminic agents represents the current treatment approach to avoid hormone release and prevent major complications. However, no standard protocols are available, resulting in great variability in terms of schedules, doses, ways of administration and timing of prophylactic treatments. MDPI 2022-01-28 /pmc/articles/PMC8833591/ /pubmed/35158931 http://dx.doi.org/10.3390/cancers14030662 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Bardasi, Camilla
Benatti, Stefania
Luppi, Gabriele
Garajovà, Ingrid
Piacentini, Federico
Dominici, Massimo
Gelsomino, Fabio
Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency
title Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency
title_full Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency
title_fullStr Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency
title_full_unstemmed Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency
title_short Carcinoid Crisis: A Misunderstood and Unrecognized Oncological Emergency
title_sort carcinoid crisis: a misunderstood and unrecognized oncological emergency
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833591/
https://www.ncbi.nlm.nih.gov/pubmed/35158931
http://dx.doi.org/10.3390/cancers14030662
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