Significant Symptom Relief with Hepatic Artery Embolization in a VIPoma with Liver Metastases.
10.3904/kjm.2014.87.3.363
- Author:
Yun Suk CHOI
1
;
Gi Young KO
;
Min Hee RYU
;
Shin Kwang KHANG
;
Jeong Eun KIM
;
Joon Seon SONG
;
Yoon Koo KANG
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. miniryu@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
VIPoma;
Liver metastases;
Hepatic artery embolization;
Diarrhea
- MeSH:
Achlorhydria;
Diagnosis;
Diarrhea;
Drug Therapy;
Hepatic Artery*;
Humans;
Hypokalemia;
Liver*;
Male;
Middle Aged;
Neoplasm Metastasis*;
Neuroendocrine Tumors;
Somatostatin;
Tumor Burden;
Vipoma*
- From:Korean Journal of Medicine
2014;87(3):363-368
- CountryRepublic of Korea
- Language:English
-
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.
