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Zollinger-Ellison syndrome — MCCQE Part 1 MCQ

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HardAbdominal PainZollinger-Ellison syndromeMCCQE Part 1

A 37-year-old woman has recurrent epigastric pain, diarrhoea, and refractory peptic ulcers. Fasting gastrin 1200 pg/mL (off PPI x 2 weeks). Secretin stimulation: paradoxical gastrin rise. Most likely diagnosis?

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Correct answer: B — Zollinger-Ellison syndrome (gastrinoma)

Markedly elevated gastrin + paradoxical rise after secretin = gastrinoma. ~25% associated with MEN-1 (check calcium/PTH). Localisation with CT/EUS, then surgical resection if possible.

Reference: Canadian NET Guidelines