Chronic Diarrhea Secondary to Newly Diagnosed VIPoma

Farina, Domenico; Krogh, Katrina; Boike, Justin R.

doi:10.1159/000494554

Cited by 9 publications

(4 citation statements)

References 14 publications

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“…The case of pancreatic VIPoma presented herein differs from other previously reported cases [9][10][11][12][13][14][15][16] in terms of the short duration and rapid progression of patient's symptoms before admission. The patient reported no similar symptoms in the past few months or intake of medications that could be responsible for diarrhea.…”

Section: Discussioncontrasting

confidence: 80%

Pancreatic Vasoactive Intestinal Peptide-Producing Tumor as a Rare Cause of Acute Diarrhea and Severe Hypokalemia

Giampatzis,

Kotsiari,

Bostantzis

et al. 2023

J Med Cases

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Pancreatic vasoactive intestinal peptide-producing tumor (VIPoma) is a rare functional neuroendocrine tumor most commonly presenting with watery diarrhea and electrolyte abnormalities that include hypokalemia, hypercalcemia and metabolic acidosis. This type of tumor has usually insidious clinical behavior that is characterized by chronic secretory diarrhea, lasting usually from months to years before diagnosis, not responsive to usual medical or dietary treatment approaches. Given the resemblance of VIPoma with other more common causes of chronic watery diarrhea, the final diagnosis is often delayed and the tumors are usually large and metastatic at the time of detection. Our case of pancreatic VIPoma demonstrates an unusual clinical course for this type of tumor with acute refractory diarrhea and rapid deterioration of patient’s clinical and biochemical status that required emergent in-hospital diagnosis and treatment. Our patient is a 45-year-old woman who presented with abrupt, watery diarrhea during the past 24 h before admission accompanied with severe hypokalemia as well as hyponatremia, hyperglycemia and hypercalcemia. Despite aggressive management with fluid administration and electrolyte replenishment, no significant improvement in patient’s symptoms and electrolyte imbalance was observed. After exclusion of other causes of acute diarrhea from the medical history and the laboratory tests, the clinical suspicion of a functional neuroendocrine tumor was raised. After the establishment of final diagnosis of pancreatic VIPoma with biochemical tests and magnetic resonance imaging (MRI), somatostatin analogues were prescribed and the patient underwent distal pancreatectomy and splenectomy with no signs of lymph node and splenic metastases. Few days after the surgical resection of the tumor, the patient readmitted to our hospital with tarry stools and severe anemia. The abdominal computed tomography (CT) revealed a retroperitoneal cystic lesion. The gastrointestinal bleeding gradually recessed after endoscopic hemostasis of duodenal ulcer lesions whereas the cystic lesion (postoperative lymphocele) was successfully drained under CT-guidance before discharge. After almost 10 years postoperatively, the patient is still asymptomatic with no signs of relapse or metastasis of the disease in the periodic laboratory and imaging follow-up. In conclusion, pancreatic VIPoma can sometimes manifest symptoms of abrupt onset and rapid progression that require high clinical suspicion, appropriate diagnostic workup and aggressive management.

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Section: Discussioncontrasting

confidence: 80%

Pancreatic Vasoactive Intestinal Peptide-Producing Tumor as a Rare Cause of Acute Diarrhea and Severe Hypokalemia

Giampatzis,

Kotsiari,

Bostantzis

et al. 2023

J Med Cases

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“…La alta concentración de PIV produce una activación de la cAMP a nivel intracelular, produciendo en los enterocitos una secreción aumentada de electrólitos, seguida de su liberación, junto con agua, a la luz intestinal, lo que origina una diarrea profusa con hipovolemia, y en algunos casos, incluso una insuficiencia renal, que suele ser la causa más frecuente de muerte en tumores secretores de PIV (Farina et al, 2019;Ito & Jensen, 2021). Las alteraciones séricas de electrólitos son típicas del síndrome de WDHA.…”

Section: Tumores Secretores De Vipunclassified

Diagnóstico y tratamiento del VIPoma o cólera pancreático.

Garcés

Vega

Palacios

2023

dilemas

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El objetivo de este estudio es poder considerar al VIPoma dentro de los diagnósticos diferenciales de patologías que provoquen trastornos graves que pudieran poner en riesgo la vida de los pacientes. El VIPoma es un tumor dependiente de la cola del páncreas que provoca el deterioro clínico del paciente, presentando varios síntomas, por lo cual es conocido como cólera pancreático. Es un tumor de alto riesgo de metástasis con silencioso desarrollo, convirtiéndose en peligroso. Esta investigación se llevó a cabo basándonos en información actualizada de bases de datos electrónicas médico-científicas. Es de suma importancia su diagnóstico temprano.

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“…The study demonstrated the high specificity of VIP levels in aiding the diagnosis of VIPomas. It is worth noting that other peptides, including gastrin and insulinoma, can also be elevated in patients with VIPomas [ 36 ].…”

Section: Diagnosis Of Functional Pannetsmentioning

confidence: 99%

An Overview of Pancreatic Neuroendocrine Tumors and an Update on Endoscopic Techniques for Their Management

et al. 2023

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The growing importance of advanced endoscopy in the diagnosis and treatment of pancreatic neuroendocrine neoplasms (PanNETs) necessitates a comprehensive understanding of various biochemical markers, genetic testing methods, radiological techniques, and treatment approaches that encompass multiple disciplines within and beyond gastrointestinal oncology. This review aims to highlight key aspects of these topics, with a specific focus on emerging EUS-guided procedures for the management of PanNETs.

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Chronic Diarrhea Secondary to Newly Diagnosed VIPoma

Cited by 9 publications

References 14 publications

Pancreatic Vasoactive Intestinal Peptide-Producing Tumor as a Rare Cause of Acute Diarrhea and Severe Hypokalemia

Pancreatic Vasoactive Intestinal Peptide-Producing Tumor as a Rare Cause of Acute Diarrhea and Severe Hypokalemia

Diagnóstico y tratamiento del VIPoma o cólera pancreático.

An Overview of Pancreatic Neuroendocrine Tumors and an Update on Endoscopic Techniques for Their Management

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