Long-term survival after diagnosis of hepatic metastatic VIPoma: report of two cases with disparate courses and review of therapeutic options.
This report describes two patients with pancreatic cholera caused by vasoactive intestinal polypeptide (VIP)-producing tumors, which originated in the pancreas and showed metastases in both hepatic lobes at time of diagnosis. However, the two tumors displayed remarkably disparate clinical courses. Due to the protracted but progressive course over more than 10 years, a multifaceted therapeutic approach was performed to control symptoms and to improve quality of life. The long-acting somatostatin analog octreotide was the most effective treatment for relieving symptoms and correcting fluid and electrolytes disturbances. The effects of complementary treatments, including systemic chemotherapy and hyperselective chemoembolization, as well as concurrent application of octreotide and prednisolone or interferon with respect to clinical symptoms, VIP levels, and tumor growth are reviewed. Our experience, although small, emphasizes the need for an expert, well-planned, adaptive, and multidisciplinary approach in the care of these complex patients.
Nguyen
H N
HN
Department of Internal Medicine III, University of Technology RWTH-Aachen, Germany.
Backes
B
B
Lammert
F
F
Wildberger
J
J
Winograd
R
R
Busch
N
N
Rieband
H
H
Matern
S
S
D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000628:therapy; D011239:Prednisolone / Q000008:administration & dosage; D011788:Quality of Life; D017741:Survivors; D013997:Time Factors; D003969:Vipoma / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy
D018931:Antineoplastic Agents, Hormonal; D011239:Prednisolone; D015282:Octreotide