Metastatic mixed VIPoma/PPoma-induced diarrhoea causing renal failure

Area of Science:

• Endocrinology
• Oncology
• Nephrology

Background:

• Vasoactive intestinal peptide-secreting tumours (VIPomas) are rare pancreatic neuroendocrine tumors causing Verner-Morrison syndrome.
• Classical symptoms include refractory diarrhea, hypokalemia, and metabolic acidosis, often leading to delayed diagnosis and metastatic disease.

Purpose of the Study:

• To report an extreme case of Verner-Morrison syndrome secondary to a mixed VIPoma/PPoma.
• To highlight the potential for severe renal failure requiring renal replacement therapy.

Main Methods:

• Case report of a patient with metastatic mixed VIPoma/PPoma.
• Management included aggressive rehydration, electrolyte replacement, and somatostatin analogue therapy.
• Renal function recovery necessitated ultrafiltration.

Main Results:

• The patient presented with severe diarrhea and dehydration, leading to acute renal failure.
• Ultrafiltration was required to restore adequate renal function.
• The tumor and metastases showed a rapid response to somatostatin analogue therapy.

Conclusions:

• This case represents a severe manifestation of Verner-Morrison syndrome, emphasizing the critical illness potential.
• Prompt diagnosis and aggressive management, including somatostatin analogues, are crucial.
• A holistic approach to patient care, including psychological support, is vital.