The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Significant Symptom Relief with Hepatic Artery Embolization in a VIPoma with Liver Metastases

간 전이를 동반한 VIPoma에서 간동맥 색전술을 이용한 현저한 증상 호전

  • Choi, Yun-Suk (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ko, Gi-Young (Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ryu, Min-Hee (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Khang, Shin Kwang (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jeong-Eun (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Joon Seon (Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kang, Yoon-Koo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 최윤숙 (울산대학교 의과대학 서울아산병원 내과) ;
  • 고기영 (울산대학교 의과대학 서울아산병원 영상의학과) ;
  • 류민희 (울산대학교 의과대학 서울아산병원 내과) ;
  • 강신광 (울산대학교 의과대학 서울아산병원 병리과) ;
  • 김정은 (울산대학교 의과대학 서울아산병원 내과) ;
  • 송준선 (울산대학교 의과대학 서울아산병원 병리과) ;
  • 강윤구 (울산대학교 의과대학 서울아산병원 내과)
  • Received : 2008.08.03
  • Accepted : 2008.10.06
  • Published : 2014.09.01
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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.

Keywords

References

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