Diagnosis and treatment of pancreatic vasoactive intestinal peptide endocrine tumors

To discuss our experience in diagnosing and treating pancreatic vasoactive intestinal peptide-secreting tumors (VIPomas) by summarizing clinical information of 4 patients.

Clinical manifestations, laboratory examination, imaging features, surgical findings, and pathological findings of 4 patients with VIPoma admitted in our hospital from 1991 to the present are discussed.

Watery diarrhea and hypokalemia were the main clinical manifestations. Hepatic metastasis occurred in 2 patients. The pancreatic body and tail were the main locations of lesions. Two tumors were shown in the pancreatic body and tail in 1 patient. Two patients with hepatic metastases received a combination therapy of octreotide, surgery, and chemotherapy, which resulted in symptom improvement and normalization of the serum potassium values. Distal pancreatic resection and second resection of hepatic metastatic lesions were performed in 1 patient. Resection of the pancreatic body and tail was done in 1 patient, and pancreatoduodenectomy was performed in another patient. Laparotomy was done in 1 patient because of invasion of the superior mesenteric vein and duodenum.

Typical symptoms play an important role in the diagnosis of VIPoma. Octreotide therapy has advanced the preoperative electrolyte management, and the combination of octreotide, chemotherapy, and surgery may be helpful in metastatic disease.