Carcinoid syndrome classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Anum Gull M.B.B.S.[2]Parminder Dhingra, M.D. [3]

Classification

• Gastroenteropancreatic neuroendocrine tumors are classified based upon their origin from the embryonic divisions of the alimentary tract:

1. Foregut (bronchial, stomach)
2. Midgut (small intestine, appendix, cecum)
3. Hindgut (distal colon, rectum, genitourinary)

• GET-NETs produce a number of secretory products, resulting in a wide range of clinical symptoms.
• Midgut gastrointestinal tract NETs (GINETs) produce serotonin and other vasoactive substances that give rise to the typical carcinoid syndrome.

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Gastroenteropancreatic neuroendocrine tumors

	Foregut	Midgut	Hindgut
Location	Stomach Duodenum Bronchus Thymus	Jejunum Ileum Appendix Ascending colon	Transverse, Descending colon Sigmoid colon Rectum Genitourinary
Hormones produced	5-hydroxytryptophan Histamine, Multiple polypeptides	Serotonin Prostaglandins, Polypeptides	Variable
Possibility of carcinoid syndrome	Rare, and atypical when it happens	Classic	Rare