26th May 2025

A 31-year-old woman presents with a history of diarrhoea and abdominal pain.

A 31-year-old woman presents with a history of diarrhoea and abdominal pain. Given hypotension she is admitted to A&E. 

She has a family history of gastric cancer.

Blood tests show:

Na 139 mmol/L (133-146)

K 2.6 mmol/L (3.5-5.5)

Creatinine 140 umol/L (baseline 60 umol/L) [normal 55-110]

Adjusted calcium 2.92 mmol/L (2.20-2.60)

Albumin 41 mmol/L (35-50)

ALT 32 mmol/L (0-34)

Bili <5 umol/L (0-21)

CRP 13 mg/L (<5)

Serum chromogranin A elevated

CT imaging showed multiple pancreatic lesions and she is listed for endoscopic ultrasound. 

What is the most likely underlying diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.