Is it Carcinoid Syndrome from Carcinoid tumor

I have been having flushing for 8 months now and had all my tests done. Tests from last month CBC normal, Bone Marrow normal for Mastocytosis,Lukeumia,Lymphoma. CT of Chest,Abdominal and Pelvis normal. Polycythemia Vera (C3,C4) in range. 5-HIAA, Seratonin in blood in range. Chromogranin A is 8 ( Normal high is 6). I had a colonoscopy in 2010 and Endoscopy last month both normal. I am on Proton Pump Inhibitor for some time. I recently had a full body Bone Scan normal. Do I need to get a Octreotide Scan to rule out Carcinoid tumor due to severe flushing of face,palms,legs and abdominal region  and weakness with some heavy breathing I do not understand what is going on.

[Christopher R Watters, MD]

Typically a 24 hour urine collection would be obtained for 5-HIAA before proceeding to the octreotide scan as it should be more sensitive to rule out carcinoid.

[smith125]

Hello Dr.Watters

I had 2 5-HIAA in the past two months and both were 3.5 MIlligrams (Range 3 to 15 milligrams). Is Octreotide Scan my last option. Does it have harmful radiation effects in the long run.

Thanks
Smith

[Christopher R Watters, MD]

The radiation is quite minimal and the risk close to none. The yield would also be low if your urinary 5-HIAA's were normal.