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A case of VIPoma

Published:September 28, 2022DOI:https://doi.org/10.1016/j.ijoa.2022.103600

      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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