[The somatostatin analog SMS 201-995 in long-term treatment of vipoma]

The definitive treatment of a pancreatic tumour secreting vasoactive intestinal polypeptide is surgical removal of the tumour, but when curative resection is not possible symptomatic treatment of the endocrine hyperfunction is important. Streptozotozin, although relative effective for palliation, may involve unpleasant side effects. A review of the literature and a case report with long-term use of subcutaneous somatostatin analogue SMS 201-995 in an elderly woman presenting with severe watery diarrhoea due to a pancreative vipoma is presented. Good symptomatic improvement was achieved with no side effects apart from tachyphylaxy to some extent over a period of 12 months. It is suggested that there is a use for subcutaneous SMS 201-995 in elderly patients with inoperable pancreatic gut hormone producing tumours with metastasis and in those in whom surgery would involve a high operative risk. Two cases are presented, where SMS 201-995 resulted in shrinkage of tumour and metastases.