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What is a Carcinoid?
A carcinoid is a rare type of tumor that can arise in the lungs—in the large airways near the center (central carcinoids) or smaller airways toward the edges (peripheral carcinoids)—and may release hormones. These tumors arise from neuroendocrine cells, which have both nerve and hormone-making properties. The Center for Thoracic Oncology specializes in treating carcinoid lung tumors, which occur slightly more frequently in African Americans and in men, and are most common between the ages of 45 and 55 years. Typical carcinoid tumors tend to be slow growing and rarely spread to other parts of the body. Atypical tumors can be more aggressive and spread more quickly than the typical carcinoids.
Symptoms of Carcinoid Tumors
Carcinoid tumors often do not cause any symptoms at all, or not until very late in the disease. When symptoms do appear, they may include:
- A group of symptoms including upper body obesity, round face, high blood pressure, hair growth, and irregular menses in women, stemming from increased production of steroids (hormones) by the adrenal and pituitary glands
- Lasting cough
- Coughing up blood
- Difficulty breathing
- Skin flushing, where the skin on the face and upper chest turns pinkish, red, or purple, and feels hot
Causes of Carcinoid Tumors
As with many cancers, it is unclear exactly what causes carcinoid tumors. Some research indicates that they arise from stem cells in the bronchial tubes. Family history and age may contribute to the formation of these tumors.
Carcinoid Tumor Treatments
If a carcinoid tumor is caught early, complete removal and cure (by surgical resection) is possible. Depending on the size and location of the tumor, resection (or removal) may involve removing part of the lung or bronchial tube, or it may only require local excision (or removal) of the abnormal tissue. Occasionally, laser or photodynamic therapy is used with surgery. After the procedure, patients are monitored in the intensive care unit to make sure they are ready to be discharged.
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Treatments & Services
The surgeon makes an incision in the center of your chest and separates the sternum (breastbone). The surgeon then locates and removes the tumor.
Thoracotomy involves the surgeon making an incision in your side, back, or in some cases between your ribs, to gain access to the desired area.
VATS stands for video-assisted thorascopic surgery. This minimally invasive alternative to open chest surgery greatly reduces patient’s pain, recovery time and risk for infection. When using VATS, the physician makes tiny incisions in the patient’s chest and inserts a thorascope (a fiber-optic camera) as well as surgical instruments. As the physician turns the thorascope, its views are displayed on a video monitor to guide surgery. The surgeon has no need to stress or cut ribs, because all movements are performed at the tip of the instrument, at the point of contact with the cancerous tissue.
Robotic-Assisted Mediastinal Tumor Resection
The surgeon uses a computer-controlled device that moves, positions, and manipulates surgical tools based on the surgeon's movements. The surgeon sits at a computer console with a monitor and the camera provides a three-dimensional view of the heart that is magnified ten times greater than a person's normal vision. The surgeon's hands control the robotic arms to perform the procedure.
Photodynamic therapy (PDT), also called photoradiation therapy, phototherapy, and photochemotherapy, has existed for about 100 years and is a type of cancer treatment that uses light to kill abnormal cells. A special drug called a photosensitizer or photosensitizing agent is circulated through the bloodstream.
Diagnostics and Tests
Chest x-rays provide an image of the heart, lungs, airways, blood vessels and bones in the spine and chest area. They can be used to look for broken bones, diseases like pneumonia, abnormalities, or cancer.
Computed Tomography (CT) Scan
CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut.
You will receive an intravenous sedative and pain medication. Once comfortable, the physician will then examine the area using an endoscope—a lighted tube with a small camera at the end. The physician will be able to view any abnormalities and take a tissue samples (biopsies) if necessary.
Magnetic Resonance Imaging (MRI)
This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be asked to drink a contrast solution for better imaging, and you will most likely lie on a moving table as pictures are taken.
Positron Emission Tomography (PET) scan
A PET scan is used to detect cellular reactions to sugar. Abnormal cells tend to react and "light up" on the scan, thus helping physicians diagnose a variety of conditions. For the PET scan, a harmless chemical, called a radiotracer, is injected into your blood stream.
Assistant Professor of Medicine, Boston University School of Medicine, Boston MA
Frank M. Shembri, MD
Clinical Associate Professor of Radiology, Boston University School of Medicine
Nuclear Medicine and Molecular Imaging
Radiology IT Officer
Clinical Associate Professor, Boston University School of Medicine
Medical Director, Clinical Cancer Center
Co-Director, BU-BMC Cancer Center
Zoltan Kohn Professor of Medicine, Boston University School of Medicine