Carcinoid tumours are rare slow growing tumours which arise from primitive neuroendocrine cells. The effect of the pregnant state on carcinoid tumours and vice versa remains unclear, as does the optimal management of carcinoid tumours during the pregnancy including labour. We report the rare case of a 36 year old primigravida woman with large bilateral pulmonary carcinoid tumours. The patient's disease was minimally symptomatic with no clinical suspicion of carcinoid syndrome. Under close observation, the pregnancy progressed well and the patient proceeded to a spontaneous vaginal delivery of a healthy child. We conduct the the first literature review in 30 years of all reported cases in this area and make suggestions as to assessment and monitoring of cases of carcinoid during pregnancy.
YaoJCHassanMPhanAet al.One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol2008; 26: 3063–3072.
2.
ThakkerRVNeweyPJWallsGVet al.Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J Clin Endocrinol Metab2012; 97: 2990–3011.
3.
SyversenUOpsjonSLStridsbergMet al.Chromogranin A and pancreastatin-like immunoreactivity in normal pregnancies. J Clin Endocrinol Metab1996; 81: 4470–4475.
4.
AsamuraHKameyaTMatsunoYet al.Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol2006; 24: 70–76.
5.
FilossoPLOliaroARuffiniEet al.Outcome and prognostic factors in bronchial carcinoids: a single-center experience. J Thoracic Oncol2013; 8: 1282–1288.
6.
FinkGKrelbaumTYellinAet al.Pulmonary carcinoid: presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature. Chest2001; 119: 1647–1651.
7.
SogaJYakuwaY. Bronchopulmonary carcinoids: an analysis of 1,875 reported cases with special reference to a comparison between typical carcinoids and atypical varieties. Ann Thoracic Cardiovas Surg1999; 5: 211–219.
8.
DuncanPGPopeWDCohenMMet al.Fetal risk of anesthesia and surgery during pregnancy. Anesthesiology1986; 64: 790–794.
9.
RinkeAMullerHHSchade-BrittingerCet al.Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group. J Clin Oncol2009; 27: 4656–4663.
10.
CaplinMEPavelMCwiklaJBet al.Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med2014; 371: 224–233.
11.
FassnachtMCapellerBArltWet al.Octreotide LAR treatment throughout pregnancy in an acromegalic woman. Clin Endocrinol2001; 55: 411–415.
12.
MaffeiPTamagnoGNardelliGBet al.Effects of octreotide exposure during pregnancy in acromegaly. Clin Endocrinol2010; 72: 668–677.
13.
SkajaaGOMathiesenERIyoreEet al.Poor pregnancy outcome after octreotide treatment during pregnancy for familial hyperinsulinemic hypoglycemia: a case report. BMC Res Notes2014; 7: 804–804.
14.
PavelMEHainsworthJDBaudinEet al.Everolimus plus octreotide long-acting repeatable for the treatment of advanced neuroendocrine tumours associated with carcinoid syndrome (RADIANT-2): a randomised, placebo-controlled, phase 3 study. Lancet2011; 378: 2005–2012.
15.
WilsonCHManasDMFrenchJJ. Laparoscopic liver resection for hepatic adenoma in pregnancy. J Clin Gastroenterol2011; 45: 828–833.
16.
BrökerMEEIjzermansJNMvan AaltenSMet al.The management of pregnancy in women with hepatocellular adenoma: a plea for an individualized approach. Int J Hepatol2012; 2012: 3–3.
17.
DaviMVBodeiLFranciaGet al.Carcinoid crisis induced by receptor radionuclide therapy with 90Y-DOTATOC in a case of liver metastases from bronchial neuroendocrine tumor (atypical carcinoid). J Endocrinol Invest2006; 29: 563–567.
18.
StrosbergWEJrChasenB. NETTER-1 phase III: progression-free survival, radiographic response, and preliminary overall survival results in patients with midgut neuroendocrine tumors treated with 177-LU-Dotatate. J Clin Oncol2016; 34: 194–194.
19.
DurkinJWJr. Carcinoid tumor and pregnancy. Am J Obstet Gynecol1983; 145: 757–761.
20.
LuostoRKoikkalainenKSipponenP. Spontaneous regression of a bronchial carcinoid tumour following pregnancy. Ann Chirurgiae et Gynaecologiae Fenniae1974; 63: 342–345.
21.
JuricaJVBaumgardnerDJ. Chlamydia and incidental carcinoid tumor in spontaneous abortion. J Am Board Fam Pract1989; 2: 126–129.
22.
GilboaYFridmanEOfirKet al.Carcinoid tumor of the appendix: ultrasound findings in early pregnancy. Ultrasound Obstet Gynecol2008; 31: 576–578.
23.
ThompsonRJHaweMJ. A rare pathological trinity: an appendiceal ectopic pregnancy, acute appendicitis and a carcinoid tumour. Irish J Med Sci2011; 180: 579–580.
24.
PoianaCCarsoteMTrifanescuRet al.Case study of appendiceal carcinoid during pregnancy. J Med Life2012; 5: 325–328.
25.
PistilliBGranaCFazioNet al.Pregnant with metastatic neuroendocrine tumour of the ovary: what now?Ecancermedicalscience2012; 6: 240–240.
26.
AbrahamPRalstonSHHewisonMet al.Presentation of a PTHrP-secreting pancreatic neuroendocrine tumour, with hypercalcaemic crisis, pre-eclampsia, and renal failure. Postgraduate Med J2002; 78: 752–753.
27.
YamamotoKAlarconJPArmengodEBet al.Tracheal carcinoid during pregnancy. J Cardiovas Surg2004; 45: 525–525.
28.
CornellRWilkensJCooperTet al.Bronchial carcinoid tumour in pregnancy. Scottish Med J2010; 55: 57–57.
LeBTBharadwajSMalinowAM. Carcinoid tumor and intravenous octreotide infusion during labor and delivery. Int J Obstet Anesth2009; 18: 182–185.
31.
SewpaulABargielaDJamesAet al.Spontaneous regression of a carcinoid tumor following pregnancy. Case Rep Endocrinol2014; 2014: 5–5.
32.
Dombrowski M, Chan J, Malviya V, et al. Ovarian carcinoid and pregnancy. A case report. J Reprod Med 1986; 31: 732–733.
33.
Smaldone GM, Richard SD, Krivak TC, et al. Pregnancy after tumor debulking and intraperitoneal cisplatin for appendiceal carcinoid tumor. Obstet Gynecol Int 2007; 110: 477–479.
