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May 1989

Vipoma Syndrome Simultaneously Occurring With Small-Cell Carcinoma of the Lung

Author Affiliations

Brussels, Belgium

Arch Intern Med. 1989;149(5):1223. doi:10.1001/archinte.1989.00390050167043

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;