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Flushing is the classic manifestation of malignant carcinoid syndrome, a group of symptoms associated with distant metastases of carcinoid tumors. Such tumors secrete a variety of neuroendocrine mediators. When they occur in the gastrointestinal tract, the mediators are metabolized by the liver and usually do not cause disease. However, when the tumors spread to the liver or develop in the lungs, the mediators enter the circulation, and distant symptoms occur. To characterize such symptoms, researchers prospectively questioned, examined, and photographed 25 patients with malignant carcinoid syndrome who were seen at a neuroendocrine tumor clinic within a 23-month period.
The primary tumor site was in the gastrointestinal tract in 16 patients…