Korean J Med.  2014 Sep;87(3):363-368. 10.3904/kjm.2014.87.3.363.

Significant Symptom Relief with Hepatic Artery Embolization in a VIPoma with Liver Metastases

• Choi YS
• Ko GY
• Ryu MH
• Khang SK
• Kim JE
• Song JS
• Kang YK

• KMID: 2269251
• DOI: http://doi.org/10.3904/kjm.2014.87.3.363

Abstract

Vasoactive intestinal polypeptide-secreting tumors (VIPomas) cause VIPoma syndrome, which is characterized by watery diarrhea, hypokalemia, and achlorhydria. The treatment options for metastatic VIPomas include somatostatin analogs, cytoreductive surgery, and chemotherapy. We report the case of a 54-year-old male who presented with a peripancreatic mass with multiple hepatic metastases on computed tomography. After resection, the peripancreatic mass was demonstrated pathologically to be a neuroendocrine tumor. Although the patient received systemic chemotherapy and somatostatin analogs for the hepatic metastatic masses, the tumor increased in size. The patient then experienced severe diarrhea, despite treatment with the somatostatin analogs. Elevated serum VIP levels (3,260 pg/mL) and typical symptoms confirmed the diagnosis of VIPoma. We performed hepatic artery embolization (HAE) to reduce the tumor volume and control his symptoms, which led to a very rapid symptomatic response. The patient has remained symptom-free for 18 months with repeated HAE.

Keyword

VIPoma; Liver metastases; Hepatic artery embolization; Diarrhea

MeSH Terms

Achlorhydria
Diagnosis
Diarrhea
Drug Therapy
Hepatic Artery*
Humans
Hypokalemia
Liver*
Male
Middle Aged
Neoplasm Metastasis*
Neuroendocrine Tumors
Somatostatin
Tumor Burden
Vipoma*
Somatostatin