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Korean J Med > Volume 87(3); 2014 > Article
The Korean Journal of Medicine 2014;87(3): 363-368.
간 전이를 동반한 VIPoma에서 간동맥 색전술을 이용한 현저한 증상 호전
최윤숙1, 고기영2, 류민희1, 강신광3, 김정은1, 송준선3, 강윤구1
1울산대학교 의과대학 서울아산병원, 내과
2울산대학교 의과대학 서울아산병원, 영상의학과
3울산대학교 의과대학 서울아산병원, 병리과
Significant Symptom Relief with Hepatic Artery Embolization in a VIPoma with Liver Metastases
Yun-Suk Choi1, Gi-Young Ko2, Min-Hee Ryu1, Shin Kwang Khang3, Jeong-Eun Kim1, Joon Seon Song3, Yoon-Koo Kang1
1Departments of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Departments of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Departments of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Min-Hee Ryu ,Tel: +82-2-3010-5935, Fax: +82-2-3010-6961, Email: miniryu@amc.seoul.kr
Received: 2008. 8. 3;  Accepted: 2008. 10. 6.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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: VIPoma; Liver metastases; Hepatic artery embolization; Diarrhea
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