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Metastatic vipoma arising from colonic primary tumour
C Bradley1, G Haddock, R G Pickard
1Department of Medical Oncology, University of Glasgow, Scotland.
Summary
A patient with ulcerative colitis developed metastatic vipoma, a rare tumor causing severe diarrhea. Treatment with a somatostatin analogue and chemotherapy effectively managed symptoms and reduced tumor size.
Area of Science:
- Gastroenterology
- Oncology
- Endocrinology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Vipomas are rare neuroendocrine tumors secreting vasoactive intestinal polypeptide (VIP).
- Hepatic metastases indicate advanced cancer stage.
Observation:
- A patient with a history of ulcerative colitis presented with a sigmoid colon tumor and liver metastases.
- High plasma levels of vasoactive intestinal polypeptide (VIP) were detected.
- The patient experienced profuse diarrhea and significant metabolic disturbances.
Findings:
- A diagnosis of metastatic vipoma was established based on clinical presentation and elevated VIP levels.
- Treatment with the somatostatin analogue SMS 201-995 alleviated severe diarrhea and metabolic upset.
- Conventional cytotoxic chemotherapy resulted in a significant tumor response and normalization of plasma VIP levels.
Implications:
- This case highlights the importance of considering rare neuroendocrine tumors in patients with inflammatory bowel disease.
- Somatostatin analogues can effectively manage symptoms associated with VIP-secreting tumors.
- Multimodal therapy, including chemotherapy, is crucial for achieving tumor response in metastatic vipoma.