Vasoactive intestinal polypeptide-secreting tumor (VIPoma) with liver metastases
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Neuroendocrine tumors often manifest an excess production of hormones that create severe metabolic abnormalities resulting in significant patient morbidity, independent of the tumor burden itself. VIPomas are rare neuroendocrine tumors arising from the pancreas and are associated with secretory diarrhea and electrolyte disturbances. We present a patient with VIPoma and hepatic metastases who had greater than 10 loose stools a day for 4 yr since diagnosis, despite debulking surgery, multiple antidiarrheal medications, large doses of octreotide, and targeted radioisotope injections. The patient required several hospitalizations for treatment of dehydration and electrolyte disturbances, despite receiving daily intravenous fluids at home. Hepatic artery embolization (HAE) immediately stopped the patient’s diarrhea and provided a return to normal formed stools without any other symptom-support measures. One year after HAE, the patient remains asymptomatic and has returned to a productive life. HAE can be a very effective and durable treatment modality for patients with metastatic VIPomas (or other neuroendocrine tumors) and who are clinically symptomatic from the effects of hormone hypersecretion.
Key WordsHepatic artery embolization VIPoma neuroendocrine tumors secretory diarrhea
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- 8.Arcenas, A.G., Ajani, J.A., Carrasco, C.H., Levin, B. and Wallace, S. (1995). Vascular occlusive therapy of pancreatic endocrine tumors metastatic to the liver, in Endocrine Tumors of the Pancreas: Recent Advances in Research and Management (Mignon, M. and Jensen, R.T., eds), pp439–446, Karger, Basel.Google Scholar
- 15.Hammond, P.J., Gilbey, S.G., Wynick, D. and Bloom, S.R. (1993). Glucagonoma, VIPoma, somatostatinoma, other hormones, and nonfunctional tumors, in Endocrine Tumors (Mazzaferri, E. and Samaan, N.A., eds), pp457–483, Blackwell Scientific, Cambridge.Google Scholar
- 17.Kvols, L.K., et al. The presence of somatostatin receptors in malignant neuroendocrine tumor tissue predicts responsiveness to octreotide. Yale J. Biol. Med. 5, 505–518.Google Scholar
- 35.Carrasco, C.H., et al. (1986). The carcinoid syndrome: palliation by hepatic artery embolization. Am. J. Roentgenol. 147, 149–154.Google Scholar
- 39.Chuang, V.P., Wallace, S., Soo, C.S., Charnsangavej, C. and Bowers, T. (1982). Therapeutic ivalon embolization of hepatic tumors. Am. J. Roentgenol. 138, 289–294.Google Scholar