Hepatic Cholera
نویسندگان
چکیده
Background and Aim: The VIPoma also known as WDHA syndrome (or pancreatic cholera) are rare neuroendocrine tumors with an incidence of 0.05% to 2%. They mostly occur in the tail pancreas but rarely may be located other segments gastrointestinal tract. Till now only very few cases extra-pancreatic solitary primary hepatic have been reported. Case Report: Our patient, 22year old gentleman, admitted recurrent chronic secretory diarrhea (>7L/day) & profound hypokalemia for two years. Preliminary workup was unrevealing. Plasma VIP were 834 pg/ml (normal-50). Ga-68 Dotatate PET CT showed a well defined, exophytic mass seen adjacent segment IVb V liver measuring 9 x 8.5 cm. lesion fairly homogenous arterial phase enhancement gradual iso attenuation portal venous phases. No calcifications seen. extra-hepatic or metastatic our extensive work-up. Octreotide therapy given patient planned surgical resection lesion. Surgical confirmed subcapsular bulging from inferior aspect liver. Following surgery, there immediate regression electrolyte abnormalities. Conclusion: first described by Werner Morrison 1958. Most (80% 90%) adults NETs, 42% 75% occurring usually diagnosed after metastasis. Rarely, 5% adults, extrapancreatic location eg ganglioneuroma, thymus, lung, kidney anterior mediastinum Diagnosis is elevated serum level functional PET-CT. Due its rarity, VIPomas included differential diagnosis diarrhea. Treatment aimed at symptom management surgery isolated tumors, whenever possible.
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ژورنال
عنوان ژورنال: Journal of clinical and experimental hepatology
سال: 2023
ISSN: ['0973-6883', '2213-3453']
DOI: https://doi.org/10.1016/j.jceh.2023.07.256