Although the carcinoid syndrome was first reported during the nineteenth century, it remains a rare entity. Merling described a tumor of the appendix that was probably carcinoid, while Langhans in 1867 documented a case microscopically.1 The theory that the crypt of Lieberkuhn is the origin of this lesion is credited to Lubarsch. In 1890 Ransom described a carcinoid tumor of the ileum that had metastasized to the liver.2 In 1897, in animal studies, Kulchitscky identified granular cells in the crypts of Lieberkuhn, noting their increase in numbers when the dogs were fed a high-protein diet. In 1907 Oberndorfer described a slow-growing intestinal tumor that appeared malignant on histologic examination but lacked the invasiveness of a carcinoma clinically. He coined the term Karzenoid meaning “resembling carcinoma”.3