Summary
A female patient suffering from a bronchial neuroendocrine tumor with unilateral leftsided carcinoid heart disease is reported. Repeated x-ray films of the chest showed a slowly growing lung tumor in the left lower lobe. The patient refused any diagnostic or therapeutic procedure to define the type of the tumor. During the follow-up of 24 years she developed severe mitral and moderate to severe aortic insufficiency, both invasively quantified by thermodilution techniques. During surgery for double valve replacement the patient died from left ventricular heart failure. Necropsy revealed the typical pattern of a bronchial neuroendocrine tumor without metastases. Examination of the heart disclosed the characteristic deposits of fibrous tissue on the cusps of both the mitral and the aortic valves whereas the right heart showed no abnormalities. Review of the literature suggests the unilateral left-sided carcinoid heart disease to be a very rare finding, its pathogenesis remains to be elucidated.
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References
Arora RR, Warner RRP (1986) Do indole markers predict carcinoid heart disease? Chest 90:98–99
Bernheimer H, Ehringer H, Heistracher P et al. (1960) Biologisch aktives, nicht metastasierendes Bronchuscarcinoid mit Linksherzsyndrom. Wien Klin Wochenschr 48:867–873
Blondal T, Grimelius L, Nou E, Wilander E, Aberg T (1980) Argyrophil carcinoid tumors of the lung. Incidence, clinical study, and follow-up of 46 patients. Chest 78:840–844
Burcharth F, Axelsson C (1972) Bronchial adenomas. Thorax 27:442–449
Creutzfeldt W, Stöckmann F (1987) Carcinoids and carcinoid syndrome. Am J Med 82 (suppl 5B):4–16
Ferrans VJ, Roberts WC (1976) The carcinoid endocardial plaque. An ultrastructural study. Hum Pathol 7:387–409
Franke WW, Winter S, von Overbeck J, Gudat F, Heitz PU, Staehli C (1987) Identification of the conserved, conformation-dependent cytokeratin epitope recognized by monoclonal antibody (lu-5). Virchows Arch A 411:137–147
Grahame-Smith DG (1968) The carcinoid syndrome. Am J Cardiol 21:376–387
Himelman RB, Schiller NB (1989) Clinical and echocardiographic comparison of patients with the carcinoid syndrome with and without carcinoid heart disease. Am J Cardiol 63:347–352
Lawson RM, Ramanathan L, Hurley G, Hinson KW, Lennox SC (1976) Bronchial adenoma: review of an 18-year experience at the Brompton Hospital. Thorax 31:245–253
Lundin L, Norheim I, Landelius J, Oeberg K, Theodorsson-Norheim E (1988) Carcinoid heart disease: relationship of circulating vasoactive substances to ultrasound-detectable cardiac abnormalities. Circulation 77:264–269
McKusick VA (1956) Carcinoid cardiovascular disease. Bull John Hop Hosp 98:13–36
Melmon KL, Sjoerdsma A, Mason DT (1965) Distinctive clinical and therapeutic aspects of the syndrome with bronchial carcinoid tumors. Am J Med 39:568–581
Norheim I, Oeberg K, Theodorsson-Norheim E et al. (1987) Malignant carcinoid tumors. An analysis of 103 patients with regard to tumor localization, hormone production, and survival. Ann Surg 206:115–125
Roberts WC, Sjoerdsma A (1964) The cardiac disease associated with the carcinoid syndrome (carcinoid heart disease). Am J Med 36:5–34
Ross EM, Roberts WC (1985) The carcinoid syndrome: comparison of 21 necropsy subjects with carcinoid heart disease to 15 necropsy subjects without carcinoid heart disease. Am J Med 79:339–354
Schweizer W, Gloor F, Bertrab R, Dubach UC (1964) Carcinoid heart disease with left-sided lesions. Circulation 29:253–257
Von Overbeck J, Staehli C, Gudat F et al (1985) Immunocytochemical characterization of an antiepithelial monoclonal antibody (mAB lu-5). Virchows Arch A 407:1–12
Wolfe HRI, Davies A, Mathias AP, Schachter M (1960) Metastatic argentaffinoma secreting 5-hydroxy-tryptamine in a patient with a patent foramen ovale. Br Med J 1:925–929
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Greminger, P., Hess, O.M., Müller, A.E. et al. Bronchial neuroendocrine (carcinoid) tumor causing unilateral left-sided carcinoid heart disease. Klin Wochenschr 69, 128–133 (1991). https://doi.org/10.1007/BF01795957
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DOI: https://doi.org/10.1007/BF01795957