Prevalence of diagnostic methods and treatment modalities in vipoma patients: A rare cause of hormone-mediated diarrhea

Abstract

Introduction: VIPoma is a neuroendocrine tumor that secrets vasoactive intestinal peptide and produces a well-defined clinical syndrome characterized by watery diarrhea, hypokalemia, hypochlorhydria and metabolic acidosis. The aim of this study to investigate clinical studies about diagnostic and therapeutic modalities of vipoma patients. In this retrospective study, all patients of vipoma were investigated. Clinical features, laboratory data at initial presentation, management and outcomes were collected. Subjects and Methods: The paper has written based on searching PubMed and Google Scholar to identify potentially relevant articles or abstracts. Categorical variables as percentage and continuous variables were reported as mean ± standard deviation (SD). Results: All the patients presented with watery diarrhea (30/30, 100%) and dehydration was reported in 33.3% of them. Prevalence of laboratory findings in these patients were assessed for hypokalaemia (25/30, 83.3%), metabolic acidosis (9/30, 33.6%), hypochloremia and achlorhydria (2/30, 6.6%). Elevated VIP levels have been seen in 73.3% patients with mean values of 882.85 ± 1134.87 pg/ml. Prevalence of diagnostic methods included CT scan in 19 patients (19/30, 63.3%), ultrasonography (15/50, 50%), and somatostatin receptor scintigraphy (8/30, 26.6%). Medical treatments included somatostatin and analogues in 18 patients (18/30, 60%). Surgery included less percentage of treatment in these patients. Conclusion: CT scan can be used as a reliable modality for diagnosis of vipoma and somatostatin analogues can be used as the most effective treatment in vipoma patients. Surveillance of these patients needs to close monitoring of patients via history, physical examination, laboratory and imaging.

Rare Cases of Pediatric Vasoactive Intestinal Peptide Secreting Tumor With Literature Review: A Challenging Etiology of Chronic Diarrhea

“…Comparatively, we described a wider range, as 0.7-15 years (mean 3.3 years, median 2 years). Although some previous literatures disclosed no strong gender predominance or even male predominance, female preponderance was noted in this series (1:2.46), as reported in a previous pediatric series (1:1.7) (3,37,38,40).…”

“…Among all-aged surveys, the median survival ranged from 70 to 96 months, whereas the mortality rate was 10 and 20% in two reviews (3,5,39,40). Including this study, three larger pediatric series disclosed an approximate mortality rate of 11-13% (1989, 11.9%; 2004, 12.3%; and 2020, 11.1%) (26,37).…”

“…Neoplasm originating from the retroperitoneal and mediastinal space comprised the majority, with a generally similar proportion of tumor location to previous reports (4). Only two pancreatic cases were identified, correlated to a recent review focusing on pancreatic NET (40). Among the measurable tumors, the mean size was 5.97 cm, ranging from 3 to 10.5 cm.…”

Surgical treatment of metastatic VIPoma: a case report

“…Besides somatostatin-analogues, possible chemotherapy options include sunitinib, everolimus, cetuximab, and rituximab. 8 , 9 Recently, treatment with lanreotide, temzolomide, and capecitabine are reported. 10 The effect of all of those mentioned is based on case reports and case series due to lack of prospective studies.…”

Treatment options of metastatic and nonmetastatic VIPoma: a review

“…The discontinuation of the treatment, however, resulted in a sudden recurrence of symptoms, although the exact underlying mechanism remained unclear. Other therapeutics, such as everolimus, cetuximab and rituximab, have been indicated in case reports as possible effective therapeutic options [27].…”