Malignant carcinoid syndrome and latest concepts in serotonin metabolism: Use of cortisone, prednisone and antiserotonin compound 45–50

Two cases of malignant carcinoid syndrome are added to the literature. In Case I the patient was actively treated with cortisone and prednisone, which produced dramatic improvement in the immediate postoperative period. Antiserotonin compound 45–50, which was used to control cor pulmonale, produced visual disturbances, drop in blood pressure and tachycardia and had to be discontinued. The second case was not clinically recognized; however, in retrospect it represented a typical case of the malignant carcinoid syndrome. Both patients had very marked albumin depletion with normal reaction to liver function tests and pronounced pellagrous skin changes.