General features:
(1) The patient has a syndrome consistent with excessive hormone production.
(2) The patient has a benign or malignant tumor.
(3) The patient shows an increased level of a hormone or hormone-like substance in serum or urine.
(4) The production of the hormone or hormone-like substance cannot be suppressed by administration of the hormone.
(5) Reduction in tumor by surgery or other therapy results in a decrease in the hormone (or hormone-like peptide) and a decrease in clinical findings (findings parallel tumor mass).
(6) There is demonstration of hormone or hormone-like peptide being produced by the tumor (see below).
Direct demonstration of hormone or hormone-like peptide production by a tumor:
(1) immunostaining of the tumor with antibodies to the hormone or peptide
(2) direct assay for the hormone or peptide in tumor cells directly or in tissue culture
(3) PCR demonstration of mRNA in the tumor capable of producing the hormone or hormone-like peptide
(4) higher levels of the hormone or hormone-like peptide in venous blood draining from a tumor than in arterial blood going to the tumor
