To the Editor.—The watery diarrhea syndrome, best called vipoma syndrome, as it is mediated by a raised plasma vasoactive intestinal polypeptide (VIP) concentration, is known to be associated with pancreatic and neural crest, but not lung, tumors.1 We describe a patient who presented with metastatic small-cell carcinoma of the lung (SCCL) and vipoma syndrome.
Report of a Case.—A 62-year-old woman was admitted for diarrhea, loss of weight, and back pain for several weeks. She had been a heavy smoker and drinker for many years. At the time of admission, she took no medication. Physical examination disclosed signs of dehydration and major liver enlargement. She had a watery diarrhea, exceeding 1.5 L daily. Results of laboratory tests showed the following results: urea nitrogen, 17.3 mmol/L; creatinine, 62 μmol/L; potassium, 2.5 mmol/L; arterial pH, 7.29; bicarbonate, 17 mmol/L; chloride, 112 mmol/L; calcium, 3.19 mmol/L;