Pancreatic vasoactive intestinal polypeptide-oma as a cause of secretory diarrhoea

A 42-year-old woman presented with a 4-year history of worsening diarrhoea that was watery, profuse and confirmed to be secretory in nature. She had t ested positive for phenolphthalein on urinary laxative screening but contin ued to deny laxative usage. Her vasoactive intestinal polypeptide (VIP) lev el was subsequently found to be markedly elevated. Despite a normal abdomin al ultrasound, a computed tomography scan revealed a 5-cm pancreatic tail m ass. Octreotide scanning was used to exclude metastatic disease and she wen t on to have surgical removal of a localized pancreatic vasoactive intestin al polypeptide-oma which resulted in the complete resolution of her diarrho ea. (C) 2000 Blackwell Science Asia Pty Ltd.