A FEMALE PATIENT 52 YEARS OLD,DIAGNOSED 3 YEARS AGO WITH METASTATIC CARCINOID TO THE LIVER,LOCALISATION OF THE PRIMARY TUMOR WAS FAILED,WAS SUBJECTED TO PARTIAL HEPATECTOMY & INTRAOPERATIVE RADIOFREQUENCY ABLATION, THEN RECIEVED 3 CYCLES OF SYSTEMIC CHEMOTHERAPY ( CISPLATIN + ETOPOSIDE ) , THEN DEVELOPED LUNG METS ,STARTED ORAL CYCLOPHOSPHAMIDE THEN SHORT ACTING SNDOSTATINE 3 TIMES DAILY WITH VERY MILD CONTROL OF THE CARCINOID SYNDROME SYMPTOMS,TWO WEEKS AGO,SUBJECTED TO PALLIATIVE TRANSARTERIAL HEPATIC CHEMOEMOLISATION& STARTED LONG ACTING SANDOSTATINE,CYPROHEPTADINE...BUT STILL SUFFERING FROM SYMPTOMS OF CARCINOD SYNDROME,,,,,,WHAT TO DO MORE ??????
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