Question:medium
What is the most common location of gastrinoma in MEN-1 syndrome?
What is the most common location of gastrinoma in MEN-1 syndrome?
Show Hint
In MEN-1 the gastrinomas are small, multiple and sit in the first part of the small bowel, not the pancreas.
Updated On: Jun 23, 2026
- Duodenum
- Jejunum
- Pancreas
- Ileum
Show Solution
The Correct Option is A
Solution and Explanation
Pin the syndrome to the tumour: MEN-1 (the 3 Ps: parathyroid, pituitary, pancreas) commonly causes pancreatic and duodenal neuroendocrine tumours, and the most common functioning one is gastrinoma, which drives Zollinger-Ellison syndrome.
Location twist in MEN-1: Although people think gastrinoma equals pancreas, in MEN-1 these tumours are characteristically small, multiple and found in the duodenal wall, clustered in the gastrinoma triangle. So the single best answer is the duodenum, option A.
Rule out the rest: The pancreas is the site for sporadic gastrinoma and for the next MEN-1 tumour, insulinoma, but it is not the most common gastrinoma site in MEN-1, so option C is not best. The jejunum and ileum are not recognised primary gastrinoma sites, so options B and D are wrong.
Clinical pearl: Suspect MEN-1 in any patient with multiple duodenal gastrinomas plus hypercalcaemia from parathyroid disease.
Ref: Bailey and Love, Short Practice of Surgery, 27e, Pg 856.
Location twist in MEN-1: Although people think gastrinoma equals pancreas, in MEN-1 these tumours are characteristically small, multiple and found in the duodenal wall, clustered in the gastrinoma triangle. So the single best answer is the duodenum, option A.
Rule out the rest: The pancreas is the site for sporadic gastrinoma and for the next MEN-1 tumour, insulinoma, but it is not the most common gastrinoma site in MEN-1, so option C is not best. The jejunum and ileum are not recognised primary gastrinoma sites, so options B and D are wrong.
Clinical pearl: Suspect MEN-1 in any patient with multiple duodenal gastrinomas plus hypercalcaemia from parathyroid disease.
Ref: Bailey and Love, Short Practice of Surgery, 27e, Pg 856.
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