A patient with MEN1 syndrome is found to have a gastrinoma. Serum gastrin is 900 pg/mL (normal <100). Secretin stimulation test shows a rise of >200 pg/mL. Which is the most common site of MEN1-associated gastrinoma?

• A Pancreatic head
• B Duodenal wall ✓
• C Gastric antrum
• D Jejunum

Explanation

In MEN1, gastrinomas are most commonly located in the duodenal wall (approximately 70–80% of cases), often small and multiple, in contrast to sporadic gastrinomas which are more frequently pancreatic. This duodenal predilection in MEN1 is important because pancreaticoduodenectomy (Whipple's) may be considered for cure. A positive secretin stimulation test (paradoxical rise >200 pg/mL) confirms gastrinoma. The gastric antrum is the site of G-cells but not the gastrinoma origin in Zollinger-Ellison syndrome.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.