These findings are consistent with a study of pulmonary and extrapulmonary LCNEC by Faggiano et al., which revealed that the first symptoms of the disease were related to tumor burden in 73% of the patients while an increase in at least one biologic marker such as serum CgA and 24-hour urinary 5HIAA was observed in 93% of patients [8]. The gene discussed is CGA; the disease is large cell neuroendocrine carcinoma.