Neuroendocrine Tumors (NET)

The most common symptoms of GEP NE tumors are diarrhea and flushing. Flushing is red or purple coloring that appears suddenly on the face or neck and may be accompanied by a feeling of warmth or a rapid heartbeat. Additional symptoms may include abdominal pain and heart disease.

• Flushing
• Diarrhea
• Heart valvular lesions
• Cramping
• Bloating
• Sweating
• Telanglectasia
• Wheezing
• Peripheral oedema
• Palpitations
• Cyanosis
• Pellagra
• Arthritis

Generally, the symptoms of GEP NE tumors vary depending on the tumor. Each type of tumor secretes different hormones that cause different symptoms. Following are the types of GEP NE tumors and their associated symptoms:

• Carcinoid tumors: Symptoms include diarrhea, flushing, cramp-like pain in the abdomen, swelling of the skin or the face and neck, wheezing, and symptoms of heart failure, including shortness of breath
• Insulinomas (hypoglycaemic syndrome): Symptoms are related to neuroglucopenia and catecholamine release and include blurred vision, diplopia, weakness, palpitations, and confusion or bizarre behavior. Hypoglycemia tends to occur 5 hours or more after a meal, and the associated symptoms may be affected by diet, ingestion of ethanol and exercise.
• Gastrinomas: Symptoms include diarrhea, gastritis and recurrent gastric ulcers. Of these tumors, 20% to 25% are related to multiple endocrine neoplasia type I and 50% to 70% are malignant (lymph node metastases)
• Vasoactive intestinal peptide (VIP) tumors (VIPomas; Verner-Morrison syndrome): Symptoms include watery diarrhea (3 to 20 litres a day), hypokalaemia due to the loss of potassium and bicarbonate in the stool, hypomagnesaemia, hypercalcemia, acidosis, flushing, flaccid distended bladder, and ileus/subileus. Diabetes or glucose intolerance also is common

Glucagonomas: Affects hepatic glucose production and causes symptoms such as necrolytic erythematous rash (often on the face, extremities, and intertriginous areas, affecting more than 80% of patients), anemia, weight loss, impaired glucose tolerance, thrombosis, and diarrhea

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