Carcinoid Heart Failure in a Metastatic Duodenal Neuroendocrine Tumor: A Challenging Case Report.
Introduction: Carcinoid heart disease (CHD) is a potenzial fatal cardiac manifestation, characterized by fibrous endocardial thickening involving right-sided heart valves. In 70% of cases, CHD occurs in advanced small bowel NETs with carcinoid syndrome (CS). Serotonin seems to play a main role. Early recognition and surgical intervention may improve the outcome of patients.
Aim(s): To evaluate if timely diagnosis and early surgical treatment in CHD patient could be effective
Materials and methods: A 64 year old woman presented with liver metastases for a well differentiated, G1, neuroendocrine tumor of the duodenum, associated with CS and CHD. The subcutaneous and intramuscular octreotide LAR (long acting release) was started. An echocardiography evidenced low ejection fraction (40%), mild mitral and pulmonary valve insufficiency, moderate aortic valve insufficiency and severe tricuspid valve insufficiency. After two months the patient underwent to aortic and tricuspid surgical replacement. However, the patient died in the intensive care unit 40 days after surgery for sepsis.
Conference: 15th Annual ENETSConcerence (2018)
Presenting Author: Brizzi M
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