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Johannes Hofland ENETS Center of Excellence, Section of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands

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Aura D Herrera-Martínez ENETS Center of Excellence, Section of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
Endocrinology and Nutrition Service, Reina Sofia University Hospital, Córdoba, Spain

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Wouter T Zandee ENETS Center of Excellence, Section of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands

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Wouter W de Herder ENETS Center of Excellence, Section of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands

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NETs is the carcinoid syndrome (CS). First described in 1931 ( Scholte 1931 ), this syndrome is characterized by the occurrence of increased bowel movements, vasoactive flushes and bronchospasms as well as long-term fibrotic changes in the mesentery and

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Yu-fang Bi Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Rui-xin Liu Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Lei Ye Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Hai Fang Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Xiao-ying Li Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases
Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Wei-qing Wang Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Ji Zhang Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Kan-Kan Wang Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Lei Jiang Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Ting-wei Su Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Zhong-yuan Chen Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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Guang Ning Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases
Department of Endocrinology and Metabolism, State Key Laboratory of Medical Genomics, Department of Thoracic Surgery, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases

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adenocarcinomas. Carcinoid tumors derived from the thymus were first documented in 1972 ( Rosai & Higa 1972 ). It can be associated with ectopic ACTH syndrome or may be a component of multiple endocrine neoplasia syndrome type 1 (MEN1). Most carcinoids are benign

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Matthew H Kulke
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Thomas O'Dorisio Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Alexandria Phan Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Emily Bergsland Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Linda Law Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Phillip Banks Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Joel Freiman Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Kenny Frazier Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Jessica Jackson Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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James C Yao Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Larry Kvols Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Pablo Lapuerta Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Brian Zambrowicz Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Douglas Fleming Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Arthur Sands Department of Medical Oncology, University of Iowa Hospitals and Clinics, The University of Texas M.D. Anderson Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, Lexicon Pharmaceuticals Inc., H. Lee Moffitt Cancer Center, Dana‐Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02115, USA

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Introduction Carcinoid syndrome is characterized by watery diarrhea, episodic flushing, bronchoconstriction, and eventually, the development of right-sided valvular heart disease. The symptoms of carcinoid syndrome have been attributed, in part, to

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Marianne Pavel Department of Gastroenterology and Hepatology, Charité–Universitätsmedizin, Berlin, Germany

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David J Gross Neuroendocrine Tumor Unit, Endocrinology and Metabolism Service, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

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Marta Benavent Laboratorio de Oncología Molecular y Nuevas Terapias, Instituto de Biomedicina de Sevilla, Sevilla, Spain
Department of Endocrinology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK

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Petros Perros Department of Endocrinology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK

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Raj Srirajaskanthan Neuroendocrine Tumour Unit, Institute of Liver Studies, Kings College Hospital, London, UK

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Richard R P Warner Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA

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Matthew H Kulke Medical Oncology/Solid Tumor Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

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Lowell B Anthony Division of Medical Oncology, University of Kentucky, Lexington, Kentucky, USA

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Pamela L Kunz Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA

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Dieter Hörsch Department of Gastroenterology/Endocrinology, Zentralklinik Bad Berka, Bad Berka, Germany

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Martin O Weickert The ARDEN NET Centre, ENETS Centre of Excellence, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

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Pablo Lapuerta Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA

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Wenjun Jiang Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA

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Kenneth Kassler-Taub Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA

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Suman Wason Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA

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Rosanna Fleming Lexicon Pharmaceuticals, Inc., The Woodlands, Texas, USA

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Douglas Fleming Ipsen Bioscience, Cambridge, Massachusetts, USA

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Rocio Garcia-Carbonero Oncology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), UCM, CNIO, CIBERONC, Madrid, Spain

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Introduction Carcinoid syndrome (CS) is a disorder that develops in up to 20% of patients with neuroendocrine tumors (NETs) and is characterized by severe diarrhea, flushing, abdominal pain, and eventually cardiac valvular complications, which

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Rebecca Dobson Department of Cardiology, Department of Obesity and Endocrinology, Clinical Sciences Centre, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK
Department of Cardiology, Department of Obesity and Endocrinology, Clinical Sciences Centre, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK

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Daniel J Cuthbertson Department of Cardiology, Department of Obesity and Endocrinology, Clinical Sciences Centre, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK

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Malcolm I Burgess Department of Cardiology, Department of Obesity and Endocrinology, Clinical Sciences Centre, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK

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Introduction Neuroendocrine tumours (NETs) are a varied group of tumours that arise from neuroendocrine precursor cells. They are rare occurring in 1.2–2.1/100 000 of the general population ( Modlin & Sandor 1997 ). Carcinoid syndrome, which is

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Larry K Kvols
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Kjell E Oberg H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Thomas M O'Dorisio H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Pharis Mohideen H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Wouter W de Herder H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Rudolf Arnold H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Ke Hu H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Yilong Zhang H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Gareth Hughes H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Lowell Anthony H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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Bertram Wiedenmann H Lee Moffitt Cancer Center and Research Institute, Department of Endocrine Oncology, Holden Comprehensive Cancer Center, Novartis Pharmaceuticals, Erasmus Medical Center, Philipps‐Universität, Novartis Pharma AG, Division of Medical Oncology, Universitätsklinikum Charité, 12902 Magnolia Drive, Tampa, Florida 33612, USA

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these amines and peptide hormones, especially serotonin and substance P, is responsible for the principal symptoms of diarrhea and flushing associated with carcinoid syndrome. Surgery is essential in the management of metastatic NETs and can be curative

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Anela Blažević Department of Internal Medicine, Sector Endocrinology, ENETS Centre of Excellence, Erasmus University Medical Center (Erasmus MC) and Erasmus MC Cancer Institute, Rotterdam, Netherlands

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Johannes Hofland Department of Internal Medicine, Sector Endocrinology, ENETS Centre of Excellence, Erasmus University Medical Center (Erasmus MC) and Erasmus MC Cancer Institute, Rotterdam, Netherlands

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Leo J Hofland Department of Internal Medicine, Sector Endocrinology, ENETS Centre of Excellence, Erasmus University Medical Center (Erasmus MC) and Erasmus MC Cancer Institute, Rotterdam, Netherlands

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Richard A Feelders Department of Internal Medicine, Sector Endocrinology, ENETS Centre of Excellence, Erasmus University Medical Center (Erasmus MC) and Erasmus MC Cancer Institute, Rotterdam, Netherlands

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Wouter W de Herder Department of Internal Medicine, Sector Endocrinology, ENETS Centre of Excellence, Erasmus University Medical Center (Erasmus MC) and Erasmus MC Cancer Institute, Rotterdam, Netherlands

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of the ability of EC cells to secrete amines and peptides can cause distinct hormonal syndromes in SI-NETs ( de Herder 2005 , Yao et al . 2008 ). Carcinoid syndrome, marked by diarrhoea and flushing, is the most established of these hormonal

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Katarina Edfeldt Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden

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Peyman Björklund Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden

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Göran Åkerström Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden

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Gunnar Westin Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden

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Per Hellman Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden

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Peter Stålberg Department of Surgical Sciences, Uppsala University, SE-751 85 Uppsala, Sweden

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( Schnirer et al . 2003 ). The tumors are neoplasms of peptide- and amine-producing cells. Some patients will develop the carcinoid syndrome due to excessive secretion of serotonin and other metabolites, which includes flushing, diarrhea, abdominal pain

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Yu-cheng Wang UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center
UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Marlene B Zuraek UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center
UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Yasuhiro Kosaka UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Yasuharu Ota UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Michael S German UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center
UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Evan S Deneris UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Emily K Bergsland UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center
UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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David B Donner UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center
UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Robert S Warren UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center
UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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Eric K Nakakura UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center
UCSF Helen Diller Family Comprehensive Cancer Center, Department of Surgery, Hormone Research Institute, Department of Medicine, Department of Neurosciences, Diabetes Center

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heart disease (i.e. carcinoid syndrome; Ishizuka et al . 1992 , von Wichert et al . 2000 ). Current therapy has limited efficacy in shrinking tumors and is ineffective in palliating symptoms in the long term ( Nakakura et al . 2007 ). Earlier

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Kjell Öberg University Hospital, Uppsala, Sweden

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Steven W J Lamberts Erasmus Medical Center, Rotterdam, The Netherlands

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). Non-functioning endocrine tumours do not secrete measurable amounts of biologically active hormones; in contrast, hormone hypersecretion from functioning GEP-NET is responsible for causing distinct clinical syndromes. Carcinoid syndrome is

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