Combination Chemotherapy of an APUDoma

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Abstract
Investigations are presented on the occurrence of tumour products during combination chemotherapy of a 49‐year‐old female with an APUDoma metastatic to the liver. Calcitonin was demonstrated in high concentration in the tumour tissue. Serum calcitonin, serum histaminase and 5‐HIAA in a 24‐hour urine sample increased immediately after the administration of cytotoxic agents, falling subsequently below the pretreatment level. These findings indicate a therapeutic effect with lysis of tumour cells. Continuous determination of the three tumour substances showed an increase in these products before clinical suspicion of progression. Electron microscopic examination during the initial course disclosed the tumour to be an APUDoma. Autopsy failed to disclose a primary site outside the liver. Further autopsy findings were an adenoma of the thyroid and a chromofobe adenoma of the pituitary, thus assigning the patient to type I multiple endocrine neoplasia.