The controversy involving the role in ZES patients of the non-surgical ablation of the primary NET (gastrinoma) for treatment is unique because in contrast to a number of other F-NETs, the hormone excess state effect resulting in gastric acid hypersecretion due to the ectopic gastrin release, can be very effective control in most patients with the potent acid antisecretory drugs available, such as the PPIs [6,33,59,60,61,62,63,64,65,66,67,68,69,70,382]. The gene discussed is GAST; the disease is gastrin-producing neuroendocrine tumor.