Introduction: Majority of pancreatic neuroendocrine tumors present with abomdinal pain and weight loss, and very few present with gastrointestinal bleeding as their initial symptom. [stlukes.com.ph]

“Finally, I just accepted the pain as something I would have to live with. I didn’t think I would ever feel well.” [foxchase.org]

The carcinoid syndrome occurs in less than 5 percent of these patients, with more common symptoms being recurrent pneumonia, cough, hemoptysis, or chest pain. [uwhealth.org]

Patients typically present with symptoms of abdominal pain or intestinal obstruction. [surgery.wisc.edu]

Other signs include pellagra, wheezing, abdominal pain, telangiectasia and heart disease (usually right sided valvular regurgitation). [wjgnet.com]

Introduction: Majority of pancreatic neuroendocrine tumors present with abomdinal pain and weight loss, and very few present with gastrointestinal bleeding as their initial symptom. [stlukes.com.ph]

Additional findings associated with glucagonoma include cheilitis, anemia, weight loss, hypoaminoacidemia, and other neuropsychiatric symptoms. [uwhealth.org]

Patients present with weight loss, jaundice, and abdominal pain. The diagnosis is confirmed by pancreatic polypeptide levels 300 pg/ml. [surgery.wisc.edu]

loss for no known reason Feeling very tired Feeling bloated Diarrhea Nausea Vomiting Colon Signs and symptoms of GI carcinoid tumors in the colon may include the following: Abdominal pain Weight loss for no known reason Rectum Signs and symptoms of GI [cancer.osu.edu]

The signs or symptoms of Zollinger-Ellison syndrome include: pain in the abdomen severe diarrhea heartburn nausea and vomiting, sometimes vomiting blood weight loss serotonin A type of neurotransmitter (a chemical that transmits signals or impulses from [cancer.ca]

This can cause muscle weakness, aching or cramps, numbness and tingling, frequent urination, fast heartbeat and feeling confused or thirsty Cramps or pain in the abdomen Weight loss for no known reason Too much somatostatin may cause: High blood sugar [cancer.osu.edu]

The first clinical manifestations of dermatomyositis are symmetrical weakness of proximal muscle, Gottron’s papules, heliotrope rash, photosensitivity, periungueal erythema, and telangiectasias. [oatext.com]

Other symptoms include abdominal pain, flushing, muscle weakness, and weight loss and can often been mistaken for carcinoid syndrome. These rare tumors occur with a frequency of 1 per 10,000,000 per year. [uwhealth.org]

Other symptoms include abdominal pain, flushing, muscle weakness, and weight loss and can often been mistaken for carcinoid syndrome. The diagnosis is made by a serum VIP level 200 pg/ml. [surgery.wisc.edu]

Primary cervical spine carcinoid tumor in a woman with arm paresthesias and weakness: A case report. J Med Case Rep 2013;7:214. 9. Zhang XF, Zhang Y, Yan X, Bie L. [asianjns.org]

At the onset of this disease, the patient suffered from intermittent fever accompanied by dull epigastric pain. The highest body temperature measured was 39 C, and the fever was treated with nonsteroidal anti-inflammatory drugs. [cancertm.com]

An infectious etiology of fever was ruled out, and a positive response to Naproxen test was indicative of neoplastic fever. [oatext.com]

Signs and symptoms include fever, chills, cough with sputum (phlegm), chest pain and shortness of breath. cortisol A hormone that helps the body use glucose (sugar), protein and fat. Cortisol is made by the adrenal gland. [cancer.ca]

Patient has not complained of fever, nausea, vomiting or jaundice. Her assessment has continued by liver sonography and abdominal CT scan and octerotid scan. Sonography has demonstrated multi cystic lesion in lever, suggestive for “Hydatid cyst”. [intjcancermanag.com]

She did not have any fever or chills. The pain was increased after eating food especially high fat food. The physical examination showed an epigastric and right upper quadrant tenderness without rebound tenderness and guarding. [canonjm.com]

Signs or symptoms of GI NETs may include: discomfort or pain in the abdomen or rectum nausea and vomiting diarrhea bleeding from the rectum or blood in the stool anemia – may cause fatigue heartburn or indigestion stomach ulcers – can cause heartburn, [cancer.ca]

The tumors cause a range of symptoms including: Fatigue Abdominal pain Wheezing Swelling in the feet and ankles Skin lesions Shortness of breath Since these can be symptoms of many conditions, it is important that any concerns be evaluated by a physician [virginiamason.org]

Some symptoms include pain, weight changes, coughing, breathing changes, tiredness (fatigue), and a change in your bowel habit. Carcinoid tumours are diagnosed by tests such as a chest X-ray, urine and blood tests and an octreotide scan. [cancer.ie]

In June 2011, the patient began to present lower limb edema, increased abdominal volume and worsening fatigue, and was admitted in September 2011 with a provisional diagnosis of decompensated heart failure. [revportcardiol.org]

Symptoms of carcinoid syndrome are: Wheezing Episodic facial flushing Severe diarrhoea Abdominal cramps Unexplained loss of appetite or weight loss Unexplained fatigue Increased heart rate Changes in blood pressure If you experience any of these symptoms [gicancer.org.au]

Carcinoid syndrome – characterized by diarrhea, flushing, dyspnea, and wheezing – may occur if a serotonin -producing tumor has metastasized to the liver, bypassing first-pass metabolism. [amboss.com]

Patient evolved to dyspnea on minimal exertion; cardiac catheterization showed no signs of coronary artery disease. [cancertreatmentjournal.com]

A 26-year-old woman presented with clinical symptoms of 2-year progression characterized by postprandial pain in the epigastrium that progressed to bloating, early satiety, dyspnea, and weight loss of 20 kg. [revistagastroenterologiamexico.org]

Figure 6: Post-OP CXR showing marked improvement and reduction of opacification of the left lung Click here to view Airway obstruction is a common feature of endobronchial tumors, presenting as dyspnea, cough, and hemoptysis. [lungindia.com]

These factors cause clinical syndromes characterized by flushing and diarrhea (gastrointestinal) or wheezing and right heart effects (bronchopulmonary). Carcinoid syndromes usually do not occur until tumors metastasize to the liver. [arupconsult.com]

Vasoactive Intestinal Peptide-Secreting Tumor (VIPoma) VIPomas are also extremely rare tumors that cause the "WDHA syndrome": watery (secretory) diarrhea, hypokalemia, and achlorhydria. [uwhealth.org]

Seven patients obtained complete relief of flushing, and four had complete relief of diarrhea. [cancernetwork.com]

Patients typically present with symptoms of abdominal pain or intestinal obstruction. These lesions may cause kinking of the bowel leading to intermittent obstruction or intestinal ischemia. [uwhealth.org]

Patients typically present with symptoms of abdominal pain or intestinal obstruction. [surgery.wisc.edu]

Most patients present with abdominal pain or jaundice. Cases of gastrointestinal bleeding that have been reported were caused by invasion of bowel wall or development of esophageal varices. Surgical resection is the primary treatment of pNET. [stlukes.com.ph]

Other signs include pellagra, wheezing, abdominal pain, telangiectasia and heart disease (usually right sided valvular regurgitation). [wjgnet.com]

pain (often secondary to fibrosis) Gastric carcinoids Type 1 associated with chronic atrophic gastritis – absent acid secretion and hypergastrinemia Type 2 associated with Zollinger-Ellison syndrome, hypergastrinemia, and MEN1 Type 3 sporadic – normal [arupconsult.com]

Dear Editor, The most reported manifestations of gastric neuroendocrine tumor (GNETs) are non-specific symptoms such as epigastric pain, nausea, dyspepsia, etc. [scielo.isciii.es]

Signs or symptoms of GI NETs may include: discomfort or pain in the abdomen or rectum nausea and vomiting diarrhea bleeding from the rectum or blood in the stool anemia – may cause fatigue heartburn or indigestion stomach ulcers – can cause heartburn, [cancer.ca]

Alert your doctor if you experience any of the following symptoms: Abdominal pain Constipation Diarrhea Change in stool color Blood in the stool Pain in the rectum Nausea Vomiting Jaundice Heartburn Weight loss Feeling very tired Feeling bloated Learn [brighamandwomens.org]

[…] you have any of the following: Duodenum Signs and symptoms of GI carcinoid tumors in the duodenum (first part of the small intestine, that connects to the stomach) may include the following: Abdominal pain Constipation Diarrhea Change in stool color Nausea [cancer.osu.edu]

[…] gain, particularly around the midsection and upper back Pink or purple marks on the skin that look like stretch marks Carcinoid tumors in the digestive tract Signs and symptoms of carcinoid tumors in the digestive tract include: Abdominal pain Diarrhea Nausea [mayoclinic.org]

The signs or symptoms of Zollinger-Ellison syndrome include: pain in the abdomen severe diarrhea heartburn nausea and vomiting, sometimes vomiting blood weight loss serotonin A type of neurotransmitter (a chemical that transmits signals or impulses from [cancer.ca]

Alert your doctor if you experience any of the following symptoms: Abdominal pain Constipation Diarrhea Change in stool color Blood in the stool Pain in the rectum Nausea Vomiting Jaundice Heartburn Weight loss Feeling very tired Feeling bloated Learn [brighamandwomens.org]

[…] in the jejunum (middle part of the small intestine) and ileum (last part of the small intestine, that connects to the colon) may include the following: Abdominal pain Weight loss for no known reason Feeling very tired Feeling bloated Diarrhea Nausea Vomiting [cancer.osu.edu]

[…] particularly around the midsection and upper back Pink or purple marks on the skin that look like stretch marks Carcinoid tumors in the digestive tract Signs and symptoms of carcinoid tumors in the digestive tract include: Abdominal pain Diarrhea Nausea, vomiting [mayoclinic.org]

Clinical features WDHA syndrome (Watery Diarrhea, Hypokalemia, Achlorhydria ) Weight loss Abdominal pain, nausea, vomiting Achlorhydria iron and B 12 absorption anemia Diagnosis Serum VIP concentration ( 75 pg/mL) Hypokalemia, hypercalcemia, hyperglycemia [amboss.com]

Pulmonary stenosis is thought to worsen tricuspid regurgitation, and the severity of pulmonary stenosis may be underestimated due to low cardiac output and severe tricuspid regurgitation. [revportcardiol.org]

Thorson A, Biorck G, Bjorkman G et al (1954) Malignant carcinoid of the small intestine with metastases to the liver, valvular disease of the right side of the heart (pulmonary stenosis and tricuspid regurgitation without septal defects), peripheral vasomotor [link.springer.com]

Cardiac examination usually yields normal results, but with prolonged, uncontrolled serotonin secretion, patients may have evidence of tricuspid valve regurgitation and, less commonly, pulmonic stenosis. The abdomen may be distended and nontender. [emedicine.medscape.com]

Echocardiography showed a normally functioning mechanical aortic valve with mild tricuspid regurgitation. Fig. 2. Coronal noncontrast magnetic resonance enterography with the arrow showing the mesenteric tumor. [karger.com]

Other signs include pellagra, wheezing, abdominal pain, telangiectasia and heart disease (usually right sided valvular regurgitation). [wjgnet.com]

Chronic obstructive pulmonary disease Anaphylaxis Foreign body obstruction Pulmonary edema Diarrhea Infections Viral Bacterial Parasitic Autoimmune bowel disease Inflammatory bowel disease Celiac disease Laxative abuse Heart valve disease Rheumatic heart [arupconsult.com]

Carcinoid heart disease: from pathophysiology to treatment--‘something in the way it moves’. Neuroendocrinology 2015; 101 (04) 263-273 21 Palaniswamy C, Frishman WH, Aronow WS. Carcinoid heart disease. [thieme-connect.com]

Carcinoid heart disease About 50% of patients with carcinoid syndrome are at risk of developing carcinoid heart disease, which characteristically affects the right side of the heart and can lead to right-sided heart failure and death. [bccancer.bc.ca]

Prognosis of carcinoid heart disease: analysis of 200 cases over two decades. Circulation, 112 (2005), pp. 3320-3327 [4] S. Bhattacharyya, J. Davar, G. Dreyfus, et al. Carcinoid heart disease. Circulation, 116 (2007), pp. 2860-2865 [5] L. Lundin, I. [revportcardiol.org]

Moller JE, Connolly HM, Rubin J et al (2003) Factors associated with progression of carcinoid heart disease. N Engl J Med 348:1005–1015 PubMed CrossRef Google Scholar 15. [link.springer.com]

Foreign body obstruction Pulmonary edema Diarrhea Infections Viral Bacterial Parasitic Autoimmune bowel disease Inflammatory bowel disease Celiac disease Laxative abuse Heart valve disease Rheumatic heart diseases Endocarditis Cardiomyopathy Pulmonary hypertension [arupconsult.com]

This tumor arising in the adrenal medulla, is associated with the over-production of epinephrine and norepinephrine that can lead to hypertension, sweating, tachycardia, weight loss and irritability. [nagourneycancerinstitute.com]

Case Report In November 2007, a 56-year-old man with hypertension presented to our hospital because of having epigastric discomfort and indigestion since sometime. [saudisurgj.org]

In both cohorts, abdominal pain (66.1% of CS cohort; 51.5% of non-CS cohort), hypertension (50.6%; 52.2%), and dyslipidemia (49.4%; 46.1%) were the most prevalent diagnoses (Table 2 ). [wjgnet.com]

A 49-year-old woman, with difficult-to-control hypertension, was admitted to the emergency ward presenting abdominal colic pain of severe intensity located in the right hypochondrium. [oatext.com]

Gastric carcinoids may cause an atypical carcinoid syndrome: flushing, hypotension, lacrimation, edema, and bronchoconstriction or may secrete adrenocorticotropic hormone (ACTH). [uwhealth.org]

The classic carcinoid syndrome associated with excess serotonin production leads to flushing, diarrhea, wheezing and in some cases hypotension, even loss of consciousness. [nagourneycancerinstitute.com]

Gastric carcinoids may cause an atypical carcinoid syndrome: flushing, hypotension, lacrimation, edema, and bronchoconstriction or may secrete adrenocorticotropic hormone ( ACTH ). [surgery.wisc.edu]

The large-scale and continuous release of bioactive substances may also cause severe hypotension and watery diarrhea. Edema of the face, rapid pulse, and pruritus may also be present. [emedicine.medscape.com]

The symptoms of carcinoid syndrome include episodes of warmth and redness of the face, head and upper chest; diarrhea; marked changes in blood pressure (usually hypotension, a decrease in blood pressure); asthmatic-like wheezing; weight loss or gain; [rarediseases.org]

References: [3] [4] [5] [1] [6] [7] Clinical features Asymptomatic Abdominal pain Carcinoid syndrome Diarrhea and abdominal cramps Cutaneous flushing Possible triggers: alcohol consumption, food intake, stress In severe cases, may be accompanied by tachycardia [amboss.com]

This tumor arising in the adrenal medulla, is associated with the over-production of epinephrine and norepinephrine that can lead to hypertension, sweating, tachycardia, weight loss and irritability. [nagourneycancerinstitute.com]

The syndrome includes flushing, diarrhea, heart failure, tachycardia, emesis, and bronchoconstriction [3]. Endoscopic ultrasonography (EUS) can be helpful for evaluating local invasion. [canonjm.com]

The diagnosis is clinical, characterized by hemodynamic instability (hypotension, tachycardia, and/or arrhythmia), hyperthermia, flushing, and bronchial obstruction. [2] Patients at risk for carcinoid crisis include those with preoperative evidence of [emedicine.medscape.com]

Symptoms are an exacerbation of the usual clinical symptoms of carcinoid syndrome, including severe flushing with or without bronchospasm, tachycardia and hypo/hypertension. [intechopen.com]

Most patients present with abdominal pain or jaundice. Cases of gastrointestinal bleeding that have been reported were caused by invasion of bowel wall or development of esophageal varices. Surgical resection is the primary treatment of pNET. [stlukes.com.ph]

RML Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow, Close Abstract Objective: Primary neuroendocrine tumors (NET) of the common hepatic duct are rare cause of malignant obstructive jaundice. [wcrj.net]

Alert your doctor if you experience any of the following symptoms: Abdominal pain Constipation Diarrhea Change in stool color Blood in the stool Pain in the rectum Nausea Vomiting Jaundice Heartburn Weight loss Feeling very tired Feeling bloated Learn [brighamandwomens.org]

Patients with jaundice only who are potentially operative candidates do not require stenting unless operative intervention will be delayed by 1-2 weeks. Patients without jaundice do not require stenting. [bccancer.bc.ca]

PNETs can also cause yellowing of skin and whites of eyes ( jaundice ) and may be benign (not cancer) or malignant (cancer). They are much less common than pancreatic exocrine tumors (pancreatic adenocarcinoma) and have a much better prognosis. [hopkinsmedicine.org]

At the time of admission to the hospital hepatomegaly develops nearly in the all of the patients. In our case he had hepatomegaly and abdominal distention in initial examination. Only in few cases (10%) reported that patients were asymptomatic. [oapublishinglondon.com]

[…] involvement of the liver, and poorly differentiated tumors. 7 In an analysis of 213 patients in the European Liver Transplant Registry, the main risk factors were multivisceral resection or multivisceral transplantation, poorly differentiated tumors, and hepatomegaly [revistagastroenterologiamexico.org]

Hepatomegaly is possible. Examination of the extremities may demonstrate bilateral lower extremity edema. [emedicine.medscape.com]

A per-abdominal examination revealed hepatomegaly and mild tenderness in the epigastrium. Further test results were: hemoglobin level and white blood cell count were normal; albumin level, 4.94 g/dl; and total protein level, 8.32 g/dl. [saudisurgj.org]

In this study the survival rate dropped to 12% in the case of hepatomegaly and primary tumour localized within the duodenum or pancreas 23. [cancertreatmentjournal.com]

Gastric carcinoids may cause an atypical carcinoid syndrome: flushing, hypotension, lacrimation, edema, and bronchoconstriction or may secrete adrenocorticotropic hormone (ACTH). [uwhealth.org]

Gastric carcinoids may cause an atypical carcinoid syndrome: flushing, hypotension, lacrimation, edema, and bronchoconstriction or may secrete adrenocorticotropic hormone ( ACTH ). [surgery.wisc.edu]

An atypical carcinoid syndrome can occur with generalized flushing, lacrimation, wheezing and diarrhea. [bccancer.bc.ca]

Episodes are often associated with an unpleasant warm feeling, itching, palpitation, upper-body erythema and edema, salivation, diaphoresis, lacrimation, and diarrhea. [emedicine.medscape.com]

These factors cause clinical syndromes characterized by flushing and diarrhea (gastrointestinal) or wheezing and right heart effects (bronchopulmonary). Carcinoid syndromes usually do not occur until tumors metastasize to the liver. [arupconsult.com]

Gastric carcinoids may cause an atypical carcinoid syndrome: flushing, hypotension, lacrimation, edema, and bronchoconstriction or may secrete adrenocorticotropic hormone (ACTH). [uwhealth.org]

Gastric carcinoids may cause an atypical carcinoid syndrome: flushing, hypotension, lacrimation, edema, and bronchoconstriction or may secrete adrenocorticotropic hormone ( ACTH ). [surgery.wisc.edu]

Since flushing is a common symptom of CS, and since flushing is often confused with the hot flashes of menopause, one might have expected males with CS to be diagnosed earlier than females if the propensity is to misdiagnose CS until the disease is well [wjgnet.com]

Carcinoid syndrome causes redness or a feeling of warmth in your face and neck (skin flushing), chronic diarrhea, and difficulty breathing, among other signs and symptoms. Carcinoid heart disease. [mayoclinic.org]

This tumor arising in the adrenal medulla, is associated with the over-production of epinephrine and norepinephrine that can lead to hypertension, sweating, tachycardia, weight loss and irritability. [nagourneycancerinstitute.com]

The signs or symptoms of pNETs include: low blood sugar levels (hypoglycemia) – may cause sweating, shakiness, dizziness, extreme hunger and problems concentrating high blood sugar levels (hyperglycemia) – may cause extreme thirst and frequent urination [cancer.ca]

Other important pathologic entities that histologically can resemble primary neuroendocrine cutaneous tumors are Merkel cell carcinoma, sebaceous neoplasms and melanoma with carcinoid-like architecture, endocrine mucin producing sweat gland carcinoma, [ncbi.nlm.nih.gov]

This was accompanied by facial erythema and numbness of the affected area. Due to the progressive enlargement of the mass, there was eventual extension to the orbital cavity resulting to compromised vision. [oncologypro.esmo.org]

Patient often present with elevated glucose and a characteristic rash called necrolytic migratory erythema seen in the face, lower abdomen, perineum, and lower extremities. Skin biopsy can occasionally confirm the diagnosis. [uwhealth.org]

Necrolytic migratory erythema is probably the most characteristic clinical feature of the glucagonoma syndrome. This skin lesion may precede the diagnosis by at least 5 years [12]. [cancernetwork.com]

Glucagonomas are very rare tumors that cause the "4D syndrome": diabetes, dermatitis, deep vein thrombosis, and depression. [uwhealth.org]

[…] asthma -like attacks) Possible weight loss despite normal appetite Palpitations Carcinoid heart disease Tricuspid insufficiency and/or pulmonary stenosis Symptoms of right-sided heart failure Possible pellagra ( niacin deficiency ) Presents as a triad of dermatitis [amboss.com]

Glucagonomas are very rare tumors that cause the “4D syndrome”: diabetes, dermatitis, deep vein thrombosis, and depression. [surgery.wisc.edu]

Niacin deficiency, also known as pellagra, is associated with dermatitis, dementia, and diarrhea. This constellation of symptoms is called carcinoid syndrome or (if acute) carcinoid crisis. [en.wikipedia.org]

Patients with glucagonomas tend to present with mild diabetes and a severe dermatitis. These tumors are frequently fairly large by the time of diagnosis, sometimes greater than two inches in diameter. Approximately 70% of these tumors are malignant. [pancreatica.org]