Therapeutic considerations for the malignant carcinoid syndrome.

Symptomatology and pathophysiology of carcinoid syndrome are summarized and the therapeutic possibilities reviewed. It is underlined that severity of symptoms and effect of the disease on vital organ function should be considered in order to tailor treatment appropriately. In some patients with a mild syndrome, symptomatic treatment of diarrhea may be sufficient while more aggressive treatment with cytotoxic drugs, interferon, somatostatin analogue or hepatic artery occlusion may be indicated in patients with severe symptoms. Carcinoid crisis is a serious, life-threatening complication of carcinoid syndrome and in this condition somatostatin analogue seems to be an especially useful addition to the therapeutic arsenal.