Octreotide Case 5 Answers

1) Any evidence for metastases?

There is diffuse liver infiltration by metastatic disease

2) Why does the presence of metastases matter?

Although most morbidity is due to the effects of carcinoid syndrome, spread has a direct bearing on survival. Complete excision usually amounts to a cure. If locally invasive, removal of all visible tissue gives excellent survival rates but late relapses occur. In patients with distant spread, the 5 year survival rate now exceeds 67%.

3) What is chromogranin A?

Chromogranins (designated A, B and C) are proteins released by neuroendocrine cells along with peptides and amines. They are sensitive markers for neuroendocrine tumours and may be used for diagnosis, as a predictor for survival and for treatment monitoring.

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