Pathology
Functional status:
Intestinal NETs
Notes: Carcinoid syndrome—symptoms and (secreted products):
− Flushing (prostaglandin, kinins, substance P)
− Diarrhea (serotonin)
− Wheezing (histamine, kinins)
− Endocardial fibrosis (serotonin)
Pancreatic NETs
Nonfunctioning: 59–76%
Functioning: 24–41%
Insulinoma: 8–17%
Gastrinoma: 10–14%
Glucagonoma: 1–6%
VIPoma: 2–5%
Notes: Functioning tumors—symptoms and (secreted products):
− Zollinger-Ellison syndrome (gastrin)
− Hypoglycemia (insulin)
− Necrolytic erythema (glucagon)
− Hyperglycemia
− WDHA (watery diarrhea, hypokalemia, and achlorhydria) syndrome (vasoactive intestinal polypeptide [VIP])
− Diabetes, gallstones, diarrhea (somatostatin)
− Cushing syndrome (corticotropin-releasing hormone [CRH], adrenocorticotropic hormone [ACTH])
− Acromegaly (growth hormone releasing hormone [GHRH], growth hormone [GH])
− Hypercalcemia (parathyroid hormone related protein [PTHrP])
− Flushing (calcitonin)
− Diarrhea (serotonin)
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