All of the following are associated with carcinoid syndrome except: September 2005

Ans. A: Cyanosis Carcinoid syndrome develops in some people with carcinoid tumors and is characterized by cutaneous flushing, abdominal cramps, and diarrhea. Carcinoid tumour occur throughout the gastrointestinal tract, most commonly in the appendix, ileum and rectum in decreasing order of frequency. Right-sided valvular hea disease may develop after several years. The syndrome results from vasoactive substances (including serotonin, bradykinin, histamine, prostaglandins, polypeptide hormones) secreted by the tumor, which is typically a metastatic intestinal carcinoid. Diagnosis is clinical and by demonstrating increased urinary 5-hydroxyindoleacetic acid. Tumor localization may require a radionuclide scan or laparotomy. Treatment of symptoms is with somatostatin or octreotide, but surgical removal is performed where possible; chemotherapy may be used for malignant tumors.