Patient with persistent diarrhea & hypotension. Diagnosis -

Ans. is 'a' i.e., VIPoma Pancreatic Neuroendocrine TumorsTumourBiologicaly active peptide secretedTumour locationMalignant percentageMain symptoms and signsGastrinoma (non b cell tumour)GastrinDuodenum (70%) Pancreas (25%) other sites (5%)60-90o Pain (79-J 00%)o Diarrhoea (30-73%)o GERD (30-35%)o Peptic ulcerInsulinoma (b cell tumour)InsulinPancreas > 99% (Insulinomas are distributed equally on head body and tail of pancrease)< 10o Symptoms of hypoglycemiao Symptoms releive on administration of glucoseVIPOMA (Verner-Morrison syndrome, pancreatic cholera (WDHA)Vasoactive intestinal peptidePancreas 90%40-70o Watery diarrhoea (90-100%)o Hypokalemia (80-100%)o Hypochlorhydriao Dehydration (83%)GlucagonomaGlucagonPancreas 100% (usually occurs singly in pancreatic tail)50-80%o Dermatitis (migratory necrolytic erythema) 67-90%o Glucose intolerance (40-90%)o Weight loss (66 to 96%)o .Anemia(33-85%)o Diarrhoea (15-29%)o Thromboembolism