A 55-year-old female with painful chronic diarrhea, multiple recurrent duodenal ulcers, and increased basal gastric acid output is most likely to hav

Functional islet cell tumors of the pancreas secrete specific substances that result in several syndromes. Pancreatic gastrinomas (tumors of the G cells of the pancreas) secrete gastrin and are a cause of Zollinger-Ellison syndrome. This syndrome consists of intractable gastric hypersecretion, severe peptic ulceration of the duodenum and jejunum, and high serum levels of gastrin. The majority of gastrinomas are malignant. Insulinomas (tumors of b cells) are the most common islet cell neoplasm and are usually benign. Symptoms include low blood sugar, hunger, sweating, and nervousness. Glucagonomas (islet cell tumors of the a cells) secrete glucagon and are characterized by mild diabetes, anemia, venous thrombosis, severe infections, and a migratory, necrotizing, erythematous skin rash. d cell tumors, which secrete somatostatin, produce a syndrome associated with mild diabetes, gallstones, steatorrhea, and hypochlorhydria. The majority of d cell tumors are malignant. D1 tumors produce Verner-Morrison syndrome, which is characterized by explosive, profuse diarrhea with hypokalemia and hypochlorhydria. This combination of symptoms is referred to as pancreatic cholera Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition