Recurrent Primary Hepatic VIPoma Treated with a Combination of Surgical Resection and Loco-Regional Therapy

Abstract

Vasoactive intestinal peptide (VIP) secreting tumors (VIPomas) are insidious functional neuroendocrine tumors originating mainly from pancreatic islet cells. Hepatic localization is considered exceedingly rare as only few cases have been reported in the literature. Diagnostic and therapeutic management of this tumor is still not clearly codified and therefore represents a real challenge for clinicians. Herein we report a unique case of a primary hepatic VIPoma recurrence in a female patient 22 years after curative resection. The patient had two sessions of transarterial chemoembolization. Complete symptomatic improvement was achieved since the first day after the first session. This case highlights that long-term follow-up for patients with hepatic VIPoma is mandatory as recurrence could occur several years after curative surgical treatment.

Plain Language Summary

VIPomas are rare tumors secreting a hormone that is vasoactive in the intestine causing severe diarrhea. The majority of VIPomas arise within the pancreas. The hepatic localization is extremely rare. We report a case of a very late recurrence of a primary hepatic VIPoma surgically treated 20 years ago. The case was managed with therapeutic radiology by blocking the blood supply to the tumors after administering anticancer drugs in the vessels near them.

Keywords:

• hepatic resection
• neuroendocrine tumor
• transarterial chemoembolization
• Vipoma

Author contributions

S Nasr, W Dahmani, K Maalel and Z Lajmi: drafting the manuscript. Y Becheikh, A Tibaoui, H Jaziri and W Ben Ameur: patient management and data collection. N Elleuch, AB Slama and S Hmissa: critical revision of the manuscript for important intellectual content. M Ksiaa and A Jmaa: final approval of the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that for investigations involving human subjects, informed consent has been obtained from the participants involved.