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J Surg Case Rep. 2019 Jun 28;2019(6):rjz196. doi: 10.1093/jscr/rjz196. eCollection 2019 Jun.

Pancreatic neuroendocrine microadenomatosis presenting as a functional VIPoma.

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St. Vincent Hospital General Surgery Residency Program, St. Vincent Hospital Indianapolis, St. Vincent Ortho Center 2001 West 86th Street, Indianapolis, IN, USA.
St. Vincent Hospital Indianapolis/North Indy Surgical Group, Indianapolis, IN, USA.
St. Vincent Hospital Indianapolis, Department of Pathology/AmeriPath Anatomic Pathology Services, Indianapolis, IN, USA.


Pancreatic microadenomas are benign tumors of neuroendocrine origin less than 5 mm in size. Whereas most microadenomas are non-functional; a few rare functional pancreatic microadenomas have been described in the setting of multiple endocrine neoplasia type one (MEN-1). In this report, we describe a unique case of multiple functional microadenomas of the pancreatic head in a patient who presented with persistent secretory diarrhea, refractory hypokalemia, metabolic acidosis and elevated plasma vasoactive intestinal peptide (VIP) levels. Following extensive serologic, radiographic and endoscopic work up, our patient underwent open pancreaticoduodenectomy with subsequent resolution of diarrheal symptoms and electrolyte abnormalities on postoperative follow up.

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