간 전이를 동반한 VIPoma에서 간동맥 색전술을 이용한 현저한 증상 호전
Significant Symptom Relief with Hepatic Artery Embolization in a VIPoma with Liver Metastases
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초록
Vasoactive intestinal polypeptide-secreting tumors (VIPomas) cause VIPoma syndrome, which is characterized by waterydiarrhea, hypokalemia, and achlorhydria. The treatment options for metastatic VIPomas include somatostatin analogs, cytoreductivesurgery, and chemotherapy. We report the case of a 54-year-old male who presented with a peripancreatic mass withmultiple hepatic metastases on computed tomography. After resection, the peripancreatic mass was demonstrated pathologically tobe a neuroendocrine tumor. Although the patient received systemic chemotherapy and somatostatin analogs for the hepaticmetastatic masses, the tumor increased in size. The patient then experienced severe diarrhea, despite treatment with the somatostatinanalogs. Elevated serum VIP levels (3,260 pg/mL) and typical symptoms confirmed the diagnosis of VIPoma. Weperformed hepatic artery embolization (HAE) to reduce the tumor volume and control his symptoms, which led to a very rapidsymptomatic response. The patient has remained symptom-free for 18 months with repeated HAE.
Abstract
Vasoactive intestinal polypeptide-secreting tumors (VIPomas) cause VIPoma syndrome, which is characterized by waterydiarrhea, hypokalemia, and achlorhydria. The treatment options for metastatic VIPomas include somatostatin analogs, cytoreductivesurgery, and chemotherapy. We report the case of a 54-year-old male who presented with a peripancreatic mass withmultiple hepatic metastases on computed tomography. After resection, the peripancreatic mass was demonstrated pathologically tobe a neuroendocrine tumor. Although the patient received systemic chemotherapy and somatostatin analogs for the hepaticmetastatic masses, the tumor increased in size. The patient then experienced severe diarrhea, despite treatment with the somatostatinanalogs. Elevated serum VIP levels (3,260 pg/mL) and typical symptoms confirmed the diagnosis of VIPoma. Weperformed hepatic artery embolization (HAE) to reduce the tumor volume and control his symptoms, which led to a very rapidsymptomatic response. The patient has remained symptom-free for 18 months with repeated HAE.
참고문헌 (17)
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