A Rare Cause of Refractory Chronic Diarrhea and Cachexia: A Case Report

Faten  HADJ KACEM; Donia CHEBBI; Amal CHAKROUN; Nadia CHARFI; Dorra GHORBEL; Fatma MNIF; Mouna MNIF; Nabila REKIK; Mohamed ABID

doi:10.18502/ijph.v49i2.3110

Faten HADJ KACEM
Donia CHEBBI
Amal CHAKROUN
Nadia CHARFI
Dorra GHORBEL
Fatma MNIF
Mouna MNIF
Nabila REKIK
Mohamed ABID

DOI: https://doi.org/10.18502/ijph.v49i2.3110

Keywords: : Neuroendocrine tumor; Somatostatin analogue; VIPoma; Secretory diarrhea; Tunisia

Abstract

VIPoma is an unusual neuroendocrine neoplasm that autonomously secretes VIP. It is associated with secretory diarrhea and electrolyte disturbances. Herein we report a case of a male patient, who was hospitalized in the Department of Endocrinology in Hedi Chaker Hospital, Sfax, Tunisia. He presented VIPoma syndrome, with hepatic metastases at diagnosis. He had a history of chronic, watery diarrhea. He was dehydrated with many electrolytic disorders as hypokalemia, hyponatremia and metabolic acidosis. Abdominal CT scan showed a heterogeneous mass in the pancreatic head with multiple hepatic lesions. A high VIP hormone level was found. Histological study of a liver biopsy revealed hepatic metastases of neuroendocrine carcinoma. The patient received analogues of somatostatin and systemic chemotherapy, with a transient symptomatic relief. Sadly the patient was lost to follow-up.