In MEN I, which is seen most commonly :
Answer is B (Gastrinoma): Amongst the options provided Gastrinomas are the most common association with MEN I. Gastrinomas > Insulinomas > Glucagonomas > VIPomos > Somatostainomas MEN I Parathyroid tumors ( Most Common) Hyperparathyroidism is the 1110S1 common manifestation of MEN I -Harrison Relative frequency of Tumors causing FR perparathyroidism : Parathyroid hyperplasia is the most common cause of hyperparathyroidisin in MEN 1 Parathyroid adenomas are less common than parathyroid hyperplasia and tend to occur in older patient or those with long standing disease. Pancreatic endocrine tumors ( Second Most Common ) Neoplasia of the pancreatic islets is the second most common manifestation of MEN P. -Harrison Relative frequency of Endocrine Tumors of Pancreatic Islets : Pancreatic polypeptide (75 - 85%) Gastrin (60%) (Gastrinomas /ZES) Insulin (25 - 30%) (Insulinomas) Glucagon (5 - I0%)(Glucagonoma) VIP (3 - 5%) (VIPomas) Somatostatin (I - 5%) (Somatostatinoma) Pituitary tumors ( Third Most Common ) Pituitary tumors are third most common tumors of MEN 1 and occur in more than half of patients with MEN 1 Relative frequency of Pituitary Tumors : Prolactinomas are the most common pituitary tumors in MEN I Acromegaly due to excessive growth hormone (GH) production is the second most common pituitary tumor in MEN I Cushing's syndrome VIPoma is synonymous with Verner Morrison syndrome or Water Diarrhea Syndrome or Pancreatic Cholera. Other Tumors in MEN I Carcinoid tumours (lbregut type : derived from lung,thymus,stomach or duodenum) Subcutaneous & visceral lipomas Cutaneous leiomyomas Skin angiofibromas or collagenomas
Insulinoma
Gastrinoma
Glucagonoma
Somatostatinoma