Casereport93DiagnosisandtreatmentofVIPomainafemalepatientCarolAnnRemmea,b,GerritH.deGrootaandGideonSchrijveraWereportacaseofVIPomainan83-year-oldfemalepatient,whopresentedwithfrequentandexcessivediarrhoea,muscleweakness,andseverehypokalaemia.Abdominalcomputedtomography（CT）revealeda46cmmassinthebodyofthepancreas.Laboratoryanalysisshowedelevatedlevelsofbothvasoactiveintestinalpolypeptide（VIP;153pmol/l）andpancreaticpolypeptide（161pmol/l）.Inviewofthepatient’sage,physicalcondition,andtumoursize,surgicalresectionwasnotperformed.Thepatientwastreatedwithalong-actingoctreotide,afterwhichhersymptomsdiminished.After24monthsoffollow-up,thepatientremainedingoodphysicalconditionwithoutanyfurtherseriousgastrointestinalsymptoms.TheVIPomasyndromeiscausedbyaneuroendocrinetumour,usuallylocatedinthepancreas,whichsecretesVIP,causingseverediarrhoea,dehydrationandhypokalaemia.Treatmentoptionsincluderesectionofthetumour,chemotherapyorthereductionofsymptomswithsomatostatinanalogues.Weprovideanoverviewoftheincidence,pathophysiology,diagnosis,treatmentstrategies,andprognosisofthisraresyndrome.EurJGastroenterolHepatol18:93C99c2006LippincottWilliams
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