Merck Manual

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Vipoma

(Werner-Morrison Syndrome)

By

Anthony Villano

, MD, Fox Chase Cancer Center

Reviewed/Revised Oct 2023
VIEW PROFESSIONAL VERSION
  • These tumors arise from cells in the pancreas that produce vasoactive intestinal peptide.

  • The main symptom is watery diarrhea.

  • Diagnosis includes blood and imaging tests.

  • Treatment is replacement of fluids and electrolytes and surgery.

Symptoms of Vipoma

The major symptom of vipoma is prolonged massive watery diarrhea. People produce 1 to 3 quarts (1,000 to 3,000 milliliters) of stool per day, causing dehydration. In 50% of people, diarrhea is constant, and in the rest, the severity of the diarrhea varies over time.

Diagnosis of Vipoma

  • Blood tests

  • Imaging tests

A doctor bases the diagnosis of vipoma on the person’s diarrhea symptoms and finding elevated levels of vasoactive intestinal peptide (VIP) in the blood.

Treatment of Vipoma

  • Replacement of fluids and electrolytes

  • Octreotide

  • Surgical removal

Initially, fluids and electrolytes (minerals in the blood such as potassium and sodium) must be replaced by vein (intravenously). Bicarbonate must be given to replace that lost in the stool and to prevent acidosis. Because water and electrolytes continue to be lost in the stool as rehydration is achieved, doctors may find it difficult to continually replace water and electrolytes.

The medication octreotide usually controls diarrhea, but large doses may be needed.

Surgical removal of the vipoma cures about 50% of people whose tumor has not spread. Surgery may temporarily relieve symptoms in people whose tumor has spread.

Chemotherapy drugs may reduce diarrhea and the size of the tumor but do not cure the disease.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Bynfezia, Mycapssa, Sandostatin, Sandostatin LAR
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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