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[Jejunal vipoma].

Monika Lecorguillé1, Pascal Hammel, Anne Couvelard

  • 1Fédération Médico-Chirurgicale d'Hépato-Gastroentérologie, Hôpital Beaujon, 100 boulevard Leclerc, 92118 Clichy.

Gastroenterologie Clinique Et Biologique
|January 14, 2005
PubMed
Summary
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A metastatic vipoma in a 57-year-old woman, causing secretory diarrhea, was successfully treated with somatostatin. Despite initial resection and chemotherapy, tumor relapse led to a liver transplant proposal.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Vipomas are rare neuroendocrine tumors often presenting with severe secretory diarrhea and electrolyte imbalances.
  • Metastatic vipoma poses significant treatment challenges, requiring multidisciplinary management.

Observation:

  • A 57-year-old woman presented with metastatic vipoma originating in the jejunum, manifesting as secretory diarrhea and profound ionic disturbances.
  • Initial treatment involved surgical resection of the primary jejunal tumor and liver metastases, followed by somatostatin administration.

Findings:

  • Somatostatin administration achieved initial successful treatment of the metastatic vipoma.
  • Despite aggressive multimodal therapy including chemotherapy (5-fluorouracil, streptozotocin, doxorubicin) and chemoembolization, early tumor relapse occurred.

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Implications:

  • This case highlights the complex management of metastatic vipoma and the potential role of somatostatin.
  • Recurrence necessitates exploring advanced treatment options such as liver transplantation for refractory metastatic neuroendocrine tumors.