Differential diagnosis of neuroendocrine tumors

Blood Diarrhea Associated Other findings

glucose conditions
Glucagonoma  ↑  Sometimes  MEN 1  Rash
 Necrolytic migratory erythema
 Neuropsychiatric symptoms
 Thrombosis
Insulinoma  ↓  No  Whipple triad
Gastrinoma  Normal  Yes  GERD
(usually steatorrhea)  PUD
VIPoma  ↑  Yes (WDHA syndrome)  Hypokalemia
 Dehydration
 Achlorhydria
Somatostatinoma  ↑  Yes (steatorrhea)  NF-1  Cholelithiasis
 Rarely MEN 1
Carcinoid tumor  Normal  Yes (watery)  MEN 1  Cutaneous flushing
 NF-1  Wheezing
 Atrophic gastritis  Carcinoid heart disease
 Pernicious anemia  Pellagra
 Zollinger-Ellison
syndrome
Pheochromocytom  Slightly ↑  No  MEN 2 A and MEN  Episodic hypertension
a
2 B  Headache
 NF-1  Diaphoresis
 VHL  Heart palpitations, tachycardia