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Episodes of facial flushing with rapid heart beat. Chromagranin A level elevated. Tumor somewhere?

My 11 year old son began having episodes of facial flushing accompanied with a rapid heart rate in September of 2011. His Chromagranin A level is elevated but all other peptides are normal. His 5HIAA is normal as well. While unusual in a child, the doctors suspected Carcinoid Syndrome as these episodes were occurring 1-2 times per day. An OctreoScan revealed a questionable spot in his lower right quadrant. He underwent surgery in March 2012 and his appendix along with 13 lymph nodes were removed. They were unable to locate any Carcinoid Tumors. Ironically, since surgery, he has only had 9 of these episodes even though the doctors were unable to locate and remove a tumor. They are not sure what to do next. Would you be inclined to believe there is still a tumor somewhere in his body since he is still experiencing some symptoms of the Syndrome? Or could there be another explanation all together for his experience? I would appreciate any advice!!
Asked On : Fri, 18 May 2012
Answers:  2 Views:  225
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Gastroenterologist 's  Response
This patient who is diagnosed with Carcinoid Syndrome and was operated for same. His Octreoscan was also positive i suppose. Now since his symptoms have recurred search on the primary tumor has to be done by repeat Octreo scan or CT scan with special look at the Pancreas and Retroperitoneum.
Answered: Tue, 3 Jul 2012
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General & Family Physician Dr. Sourav Ganguly's  Response
Hi kelliclark1.

Thanks for your question.

It is a recurrance of carcinoid sympoms due to local or distant recurrance of the primary tumor so please do a repeat octreo scan TO SEARCH FOR PRIMARY AND TREAT THEM.

please consider your gastroenterologist for further opinion.

best wishes
Answered: Tue, 3 Jul 2012
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