Lowell B. Anthony, MD, FACP

Small intestinal “carcinoid” or well-differentiated grade 1 neuroendocrine tumors can have an insidious onset or be diagnosed serendipitously at the time of surgery, during the workup for another disorder, or during a screening test.

Much progress in the diagnosis and management of well-differentiated neuroendocrine malignancies is evident over the past 2 decades. Initial medical intervention using somatostatin analogs such as octreotide acetate in the immediate and sustained release formulations (Sandostatin and Sandostatin LAR Depot) is standard for the symptomatic stage IV patient.[1,2] Somatostatin analogs provide effective hormonal suppression for carcinoid neoplasm, pancreatic islet cell malignancies, and pituitary adenomas.