Highlights
- •VIPoma is a rare neuroendocrine tumour with multisystem effects.
- •A multidisciplinary approach to management in a specialist centre is vital.
- •Management of electrolytes and avoidance of triggers for VIP secretion are key.
- •Reduce large changes in sympathetic tone during labour with epidural analgesia.
- •Administration of a somatostatin analogue inhibits VIP secretion.
Abstract
This case report addresses the management of a pregnant woman in the peripartum period
with a VIPoma. This rare and highly malignant neuroendocrine tumour secretes vasoactive
intestinal peptide (VIP), a substance that may cause potentially life-threatening
disruption to physiology.
A 36-year-old woman presented for induction of labour with a three-year history of
chronic diarrhoea, hypophosphataemia, palpitations and skin flushing. Raised VIP levels
indicated presence of a VIPoma, however despite extensive investigation prior to pregnancy
by neuroendocrine specialists, the tumour location remained unidentified.
The patient delivered a healthy boy with the aid of forceps in theatre following an
epidural top-up. Key features of management were a multidisciplinary approach, avoidance
of triggers for VIP secretion, strict management of electrolytes and avoidance of
severe changes in sympathetic tone during labour with epidural analgesia.
Keywords
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Article info
Publication history
Published online: September 28, 2022
Accepted:
September 23,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
