Ghrelin is a novel gastrointestinal hormone that exerts a wide range of metabolic functions. It promotes growth hormone release. It is an important regulator of energy balance. It has been demonstrated to increase appetite and food intake and modulate insulin secretion. It has significant homology with motilin and it stimulates gastric contractility and acid secretion. A study demonstrated that one patient with an apparently nonfunctional pancreatic neuroendocrine tumor had markedly elevated serum levels of ghrelin. Further, immunohistochemistry of tumor showed intense focal cytoplasmic positivity for ghrelin. This study suggested that the patient had a tumor that secreted ghrelin, a so-called ghrelinoma. This had not been previously described. The authors examined many other carcinoid and pancreatic neuroendocrine tumors and no other tumor had detectable levels of ghrelin or stained positive for ghrelin.74

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