Introduction: Carcinoid tumors are rare, originates from neuroendocrine cells, with typical hystological
characteristics. Despite their common origin, tumors at different locations have different
clinical manifestations.
Case study: 1st case: 36 year old woman was investigated because of aneamia. A polyp has been
found in the rectum, and has been removed. Histology proved carcinoid tumor (chromogranin
A ++, VIP – neg., somatostatin +, serotonin neg., somatostatin receptor neg). The
patient had no typical symptoms to carcinoid. The polypectomy was complete. Serum
chromogranin A level was 8.5ng/ml (in normal range).
2nd case: 60 year old woman underwent investigations because of anaemia, too. Two
solid polyps (4 and 9mm) were detected during gastroscopy. After biopsy, they were
proved histologically to carcinoid tumors (chromogranin A ++, p53 neg. COX2 neg.,
somatostatin neg., insuline neg.). Endosonography proved the intramucosal location
of the tumor. Hystology showed lymphatic invasion, therefore, the stomach was resected.
Pathology proved lymphatic invasion in the submucosus layer. Serum chromogranin A
level was 237.7ng/ml (high).
Discussion: There were no typical symptoms of carcinoid syndrome in either cases. Endosonography
and specific immunohystochemistry (chromogranin A, somatostatin, C -kit, serotonin,
p53, insuline, VIP) might be helpful planning the therapy. Serum chromogranin A test
is recommended in the follow up carcinoid tumors.
Conclusion: After removing small polyps with unusual look, only histology may prove its carcinoid
origine. Immunohystochemistry, endosonography and serum chromogranin A level determine
the therapy of patients with carcinoid tumors.
