Use of a somatostatin analog to improve a patient's condition and the subsequent diagnosis of pancreatic VIPoma: A case report

Soichiro Kawahara, Toru Ueki, Koichiro Tsutsumi, Takashi Oda, Sayo Kobayashi, Tomoo Fujisawa, Toru Nawa, Hiroshi Sadamori, Kyotaro Ono, Kunihiro Omonishi

Research output: Contribution to journalArticlepeer-review

Abstract

A 68-year-old woman with an 11-day history of sudden abdominal pain and severe watery diarrhea was transferred to our hospital due to an exacerbation of renal function despite hydration. After treatment for dehydration and acidemia was provided in our intensive care unit, patient's renal function improved. Contrast-enhanced abdominal computed tomography was finally performed, revealing a hypervascular pancreatic mass with multiple hepatic masses. This imaging finding along with her clinical symptoms indicated watery diarrhea hypokalemia achlorhydria (WDHA) syndrome caused by a pancreatic VIPoma. Somatostatin analog was administered immediately leading to the improvement of her diarrhea and her general condition. As a result, endoscopic ultrasonography-guided fine-needle aspiration could be performed. Consequently, she was diagnosed with a pancreatic neuroendocrine tumor. She then underwent surgical resection of the pancreatic tumor and liver metastasis. As revealed in the immunohistochemical analysis of the excised tumor tissue, VIP was highly expressed, resulting in the final diagnosis of pancreatic VIPoma. Therefore, the immediate use of a somatostatin analog is crucial for improving the patient's general condition and achieving a definitive diagnosis pathologically when a patient is suspected of having a pancreatic VIPoma.

Original languageEnglish
Pages (from-to)84-91
Number of pages8
JournalJournal of Japanese Society of Gastroenterology
Volume117
Issue number1
DOIs
Publication statusPublished - 2020
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology

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