American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the treatment for symptomatic carcinoid tumors?

1. Chemotherapy

2. Radiation therapy

3. Octreotide

4. Surgical resection

The correct answer is: Octreotide

Carcinoid tumors, which typically arise from neuroendocrine cells in the gastrointestinal tract or other locations, can secrete various substances, including serotonin, leading to symptoms such as flushing, diarrhea, and wheezing. The primary treatment for symptomatic carcinoid tumors is the use of octreotide, a somatostatin analog. Octreotide works by binding to somatostatin receptors, which inhibits the release of serotonin and other vasoactive substances produced by the tumor. This not only helps in reducing the symptoms experienced by the patient but also has a role in managing tumor growth. It is particularly effective in alleviating symptoms of carcinoid syndrome, which includes flushing and diarrhea. While surgical resection is an important treatment modality for carcinoid tumors when feasible, especially for localized disease, octreotide is often the first-line therapy for symptom relief in patients experiencing significant symptoms related to their tumors. Chemotherapy and radiation therapy are generally less effective for carcinoid tumors compared to their use in other tumor types, making octreotide the preferred choice for symptomatic management.