well....the TR is not a hard find, the obvious neck vein pulses, but to connect that to metastatic carcinoid or VIPoma??? themselves a super rare diagnoses (symptomatic carcinoid ive seen a maybe a few times, VIPoma, never, the rarest of neuroendocrine tumors), and just by looking at him say oh yes, an obvious neuroendocrine tumor....gimme a break, i dont believe it. could have easily guessed a million other things, and once in a while you guess right.
augenblick my ass