MCQ Surgery Answer 20

Pancreatic endocrine tumor, functional

Insulin-secreting (insulinoma) (hypoglycemia, neuropsychiatric disturbances)

Glucagon-secreting (glucagonoma) (diabetes, skin rash [necrolytic migratory erythema], stomatitis)

Gastrin-secreting (gastrinoma) (abdominal pain, ulcer disease, diarrhea, gastrointestinal bleeding)

Somatostatin-secreting (somatostatinoma) (diabetes mellitus, cholelithiasis, steatorrhea, hypochlorhydria)

Pancreatic polypeptide (PP)-secreting (PP-oma) (clinically silent but with elevated serum PP levels)

Vasoactive intestinal polypeptide (VIP)-secreting (VIP-oma) (watery diarrhea, hypokalemia, achlorhydria)

Adrenocorticotropic hormone-producing (Cushing’s syndrome: central obesity, muscle weakness, glucose intolerance, hypertension)

Carcinoid tumor (serotonin-producing) (carcinoid syndrome: flushing, diarrhea)

1. Insulinoma
1. Most common islet cell tumor
2. May secrete enough insulin to cause hypoglycemia
3. Sxs: confusion, stupor, loss of consciousness
4. Morphology
1. most are solitary adenomas, 10% are multiple, 10% are metastatic
2. See diffuse islet hyperplasia, with normal β cells (rectangular granules)
2. Gastrinoma (Zollinger-Ellison syndrome)
1. Triad of disease: peptic ulcers, gastric hypersecretion, endocrine gastrin-secreting tumor
2. 60% are malignant
3. Histology is similar to normal G cells
4. Pts present with severe diarrhea, fluid/electrolyte imbalance and malabsorption
3. Glucagonoma
1. sxs similar to diabetes mellitus; have migratory skin erythema and anemia
4. Somatostatinoma
1. sxs: diabetes mellitus, cholelithiasis, steatorrhea, hypochlorhydria
5. VIPoma
1. sxs: watery diarrhea, hypokalemia, achlorhydria; associated with neural crest tumors

Category: Surgery MCQs