VIPoma: An Unusual Cause of Chronic Diarrhea.

Sutharin Suteetorn, Krit Kitisin, Natcha Wanpiyarat, Supaksorn Kunjan, Thiti Snabboon
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Abstract

Chronic diarrhea is a significant challenge in clinical practice because of its high prevalence and various causes. Comprehensive clinical assessment and stepwise laboratory approach are crucial for an accurate diagnosis. This report presents a case of an adult woman who experienced chronic watery diarrhea, complicated by renal impairment and multiple electrolyte imbalances, including hypokalemia, hypophosphatemia, and metabolic acidosis. The diagnosis of a vasoactive intestinal polypeptide-secreting tumor (VIPoma) with liver metastases was confirmed by elevated serum levels of a vasoactive intestinal polypeptide (VIP) and imaging findings of a pancreatic mass with multiple hepatic lesions. Preoperative management, including fluid rehydration, electrolyte correction, and somatostatin analog therapy, significantly improved her clinical symptoms. Subsequent surgical tumor removal and radiofrequency ablation of the hepatic lesions resulted in complete resolution of symptoms and normalized VIP levels. This case emphasizes the importance of early recognition of this rare tumor in patients with chronic diarrhea to improve clinical outcomes.

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VIPoma:慢性腹泻的不寻常原因
慢性腹泻发病率高,病因多样,是临床实践中的一大难题。全面的临床评估和循序渐进的实验室方法是准确诊断的关键。本报告介绍了一例成年女性慢性水样腹泻病例,该病例并发肾功能损害和多种电解质失衡,包括低钾血症、低磷血症和代谢性酸中毒。血清中血管活性肠多肽(VIP)水平升高,影像学检查发现胰腺肿块伴有多处肝脏病变,确诊为血管活性肠多肽分泌性肿瘤(VIP瘤)伴肝脏转移。术前处理,包括液体补液、电解质纠正和体泌素类似物治疗,明显改善了她的临床症状。随后通过手术切除肿瘤并对肝脏病灶进行射频消融,症状完全缓解,VIP 水平恢复正常。本病例强调了在慢性腹泻患者中早期识别这种罕见肿瘤以改善临床疗效的重要性。
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