VIPoma

Last reviewed: 6 Sep 2022
Last updated: 06 Apr 2022

Summary

Definition

History and exam

Key diagnostic factors

  • watery diarrhoea
More key diagnostic factors

Other diagnostic factors

  • age around 50 years
  • headache
  • weight loss
  • poor skin turgor
  • flushing
  • history of multiple endocrine neoplasia type 1 (MEN1)
Other diagnostic factors

Risk factors

  • multiple endocrine neoplasia type 1 (MEN1)
  • age around 50 years
More risk factors

Diagnostic investigations

1st investigations to order

  • serum potassium
  • serum bicarbonate
  • serum calcium
  • serum glucose
  • vasoactive intestinal peptide (VIP) radioimmunoassay
  • liver function tests
More 1st investigations to order

Investigations to consider

  • arterial blood gas analysis
  • gastric pH monitoring
  • chromogranin A
  • pancreatic polypeptide
  • ultrasound
  • contrast-enhanced thin-slice CT scan of abdomen
  • contrast-enhanced MRI of abdomen
  • somatostatin receptor scintigraphy
  • endoscopic ultrasound
  • operative exploration
  • intraoperative ultrasound
  • positron emission tomography (PET)/CT
More investigations to consider

Treatment algorithm

ACUTE

initial presentation of symptomatic patient

ONGOING

localised disease

metastatic disease: surgical candidate

metastatic disease: non-surgical candidate

Contributors

Authors

Harish Lavu, MD, FACS
Harish Lavu

Associate Professor of Surgery

Jefferson Medical College

Thomas Jefferson University

Philadelphia

PA

Disclosures

HL declares that he has no competing interests.

Charles J. Yeo, MD, FACS
Charles J. Yeo

The Samuel D. Gross Professor and Chair

Department of Surgery

Jefferson Medical College

Thomas Jefferson University

Philadelphia

PA

Disclosures

CJY declares that he has no competing interests.

Peer reviewers

Jaime Ruiz-Tovar, MD

Fellow of the Spanish Association of Surgeons (AEC)

Department of Surgery

University Hospital Ramon y Cajal

Madrid

Spain

Disclosures

JRT declares that he has no competing interests.

Christopher Wolfgang, MD, PhD, FACS

Assistant Professor of Surgery and Oncology

Cameron Division of Surgical Oncology

The Sol Goldman Pancreatic Cancer Research Center

Johns Hopkins University

Baltimore

MD

Disclosures

CW declares that he has no competing interests.

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    • Ileal bile acid malabsorption
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    • NCCN clinical practice guidelines in oncology: neuroendocrine and adrenal tumors
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  • Patient leaflets

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