Case Report of Recurrent VIPoma
Introduction: 51yr presented with 7 month diarrhoea&2 stone weight loss. All tests negative, only abnormality hypokalaemia. FGH profile: VIP raised>400, peptide histidine methionine>1000, GAWK of 250. Diagnosis of VIPoma. CT: 5cm mass tail & body of pancreas, no hepatic or adrenal lesions. Octreotide treatment started. Bowel frequency improved, hypokalaemia corrected. Octreotide scan showed uptake only in pancreas. Patient readmitted 5 months later hypokalaemic myopathy, K 1.7, surgical distal pancreatectomy & splenectomy completed. Histology: NET within pancreas, moderate cellular differentiation, variable mitotic rate.
Aim(s): Tumour enclosed in capsule, showed capsular invasion. Patient discharged, followed-up 9yr, no signs of recurrence.
Materials and methods: 11yr on patient referred on cancer pathway with diarrhoea, no electrolyte changes. Colonoscopy: normal. CT: tumour recurrence in pancreatic bed. CgA120, CgB89, VIP130, other FGH normal. Ocreotide scan: uptake left upper quadrant & epigastrium. USS biopsy: NET minimal cellular differentiation, no evidence mitotic activity, positive chromogranin & synaptophysin, low Ki67 <5%.
Conference: 12th Annual ENETSConcerence (2015)
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