Carcinoid syndrome classically presents with flushing, diarrhoea, asthma and high levels of 5HT (5-hydroxytryptamine). This syndrome is only very rarely caused by pancreatic carcinoid tumours that have metastasised to the liver.
The treatment of choice of pancreatic carcinoid tumours is surgery. The surgery may involve a Whipple's procedure for a tumour of the head of the pancreas (see surgery section for further details). A distal pancreatectomy may be used for a lesion in the rest of the gland.
The metastases are treated by debulking combined with either chemotherapy (using streptozotocin) or hepatic artery embolization.
Somatostatin analogues (octreotide) have been shown to be effective in symptom relief, but have no effect on tumour size. Recent studies have shown that human leucocyte interferon has some beneficial effects.