Diagnosis, treatment, and current concepts in the endoscopic management of gastroenteropancreatic neuroendocrine neoplasms

Table 2 The hormones produced by the primary gastroenteropancreatic neuroendocrine neoplasms

Tissue	Hormones	Symptoms/Syndrome
Gastric	Histamine, CGA	Atypical flush, wheeze, angioedema
Duodenal	CGA, somatostatin, gastrin	Cholelithiasis, steatorrhea, diabetes, ZE syndrome (gastrinoma)
Jejuno-ileal, appendiceal, cecal	Serotonin, CGA, pancreastatin	Carcinoid syndrome
Colorectal	Pancreatic polypeptide	No hormonal symptoms
Pancreatic	Insulin	Recurrent hypoglycemia
	Glucagon	Diarrhea, glossitis, necrolytic migratory erythema, weight loss, hyperglycemia, blood clots
	VIP	Diarrhea, hypokalemia, achlorhydria
	ACTH	Cushingoid facies, weight gain, diabetes, hypertension
	GHRH	Acromegalic features, diabetes
	PTHRP	Hypercalcemia
	Gastrin	Pain, diarrhea (ZE syndrome)
	Somatostatin	Diabetes, cholelithiasis, steatorrhea, weight loss
	Serotonin	Flushing, diarrhea (carcinoid syndrome)

5HIAA: 5-hydroxyindoleacetic acid; ACTH: Adrenocorticotrophic hormone; CGA: Chromogranin A; F-PNET: Functional pancreatic neuroendocrine tumor; GHRH: Growth hormone releasing hormone; MEN1: Multiple endocrine neoplasia type 1; NF1: Neurofibromatosis type 1; PTHRP: Parathyroid hormone-related peptide; VIP: Vasoactive intestinal polypeptide; ZE: Zollinger Ellison.