Octreotide reverses shock due to vasoactive intestinal peptide-secreting adrenal pheochromocytoma: A case report and review of literature

作     者：Xiao Hu Wei Cao Min Zhao 无

作者机构：Department of Emergency MedicineShengjing Hospital of China Medical University Department of Pathology Shengjing Hospital of China Medical University 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2018年第6卷第14期

页      面：862-868页

核心收录：

学科分类：1006[医学-中西医结合] 1002[医学-临床医学] 10[医学] 100602[医学-中西医结合临床] 

基　　金：Supported by National Clinical Specialty Construction Project No.2012649 

主　　题：血管活性肠肽 肿瘤 胰腺 激素 

摘      要：Vasoactive intestinal peptide-producing tumors(VIPoma) usually originate in the pancreas and are characterized by diarrhea, hypokalemia, and achlorhydria(WDHA syndrome). In adults, nonpancreatic VIPoma is very rare. Herein, we report an unusual case of VIPproducing pheochromocytoma marked by persistent shock, flushing, and watery diarrhea and high sensitivity to octreotide. A 53-year-old woman was hospitalized for sudden-onset hypertension with convulsions, which then rapidly evolved to persistent shock, flushing, and watery diarrhea. Abdominal computed tomography indicated a left adrenal mass, accompanied by bleeding; and marked elevations of both plasma catecholamine and VIP concentrations were documented via laboratory testing. Surprisingly, all clinical symptoms responded swiftly to octreotide treatment. Once surgically treated, hormonal levels normalized in this patient, and the clinical symptoms dissipated. Postoperative pathological and immunohistopathological studies confirmed a VIPsecreting pheochromocytoma with strong, diffuse positivity for somatostatin receptor type 2. During a 6-mo follow-up period, she seemed in good health andwas symptom-free.