A Carcinoid Saga

The case is reported of a patient who developed the carcinoid syndrome when metastases appeared in the liver after resection of the primary ileal tumour. A right hepatic lobectomy was followed by complete remission of symptoms for 15 months, even though local removal of further liver metastases became necessary because of biochemical evidence of recurrence. Finally, systemic spread of the tumour became apparent. Two years after the original resection the patient appeared to be in the terminal phase of the disease. The protean manifestations of the carcinoid syndrome are reviewed, and the conclusion is reached that surgical removal of liver metastases can produce worth‐while palliation even in the presence of advanced disease. The importance of proper operative management, including anaesthesia, is stressed. More long‐term study and the publication of complete case reports seem necessary to delineate the prognosis of the carcinoid syndrome when this is treated surgically.