VIPoma — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardEndocrinology & DiabetesVIPomaRACP Adult Medicine

A 50-year-old woman presents with severe watery diarrhoea (10 L/day), dehydration, and hypokalaemia. She has flushing and a pancreatic mass on CT. What is the most likely hormonal syndrome?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Somatostatinoma

VIPoma (vasoactive intestinal peptide-secreting tumour) presents with the WDHA syndrome: Watery Diarrhoea (secretory – persists with fasting), Hypokalaemia, and Achlorhydria. The massive secretory diarrhoea (>3 L/day, often >5 L/day) causes severe dehydration and electrolyte depletion. Fasting VIP levels are markedly elevated (>75 pg/mL). Most VIPomas are pancreatic islet cell tumours. Treatment includes fluid/electrolyte replacement, octreotide (reduces VIP secretion and diarrhoea), and surgical resection if feasible. Unlike carcinoid syndrome, 5-HIAA is normal.

Reference: eTG – 2025 – Endocrinology; NCCN – 2025 – Neuroendocrine Tumour Guidelines