Radiofrequency ablation has a valuable therapeutic role in metastatic VIPoma.
BACKGROUND
Vasoactive intestinal peptide-secreting tumours (VIPomas) are rare islet cell tumours of the pancreas that can result in life-threatening biochemical abnormalities. The optimal intervention for metastatic VIPoma remains undecided. This case history documents the clinical role of radiofrequency (RF) ablation in the treatment of metastatic VIPoma.


METHODS
A primary pancreatic VIPoma was diagnosed in a 61-year-old female in 1998 and a distal pancreatectomy and splenectomy were performed. She remained disease-free for 44 months when she presented as an emergency with watery diarrhoea, hypokalaemia, renal failure and an elevated serum VIP level. CT scanning showed a liver metastasis and open RF ablation was performed with complete resolution of symptoms and biochemistry within 48 h. Post-ablation imaging confirmed complete ablation of the metastasis. She remained disease-free until 22 months later when watery diarrhoea resumed and a new hepatic metastasis was seen on CT. Percutaneous RF ablation was performed and follow-up CT scan showed complete ablation of the metastasis. The patient remains disease- and symptom-free 10 months after the second RF ablation.


CONCLUSIONS
This case illustrates that the pronounced clinical and biochemical upset caused by metastatic VIPoma can be resolved safely, quickly and repeatedly by RF ablation.
Moug
Susan J
SJ
Department of Surgery, Glasgow Royal Infirmary, Glasgow, UK.
Leen
Edward
E
Horgan
Paul G
PG
Imrie
Clement W
CW
D015415:Biomarkers; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology*; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D016312:Treatment Refusal; D003969:Vipoma / Q000473:pathology*
D015415:Biomarkers