Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 14, 2007; 13(34): 4649-4652
Published online Sep 14, 2007. doi: 10.3748/wjg.v13.i34.4649
Watery diarrhea, hypokalemia and achlorhydria syndrome due to an adrenal pheochromocytoma
Shin-ichi Ikuta, Chiaki Yasui, Masahiro Kawanaka, Tsukasa Aihara, Hidenori Yoshie, Hidenori Yanagi, Masao Mitsunobu, Ayako Sugihara, Naoki Yamanaka
Shin-ichi Ikuta, Chiaki Yasui, Tsukasa Aihara, Hidenori Yoshie, Hidenori Yanagi, Masao Mitsunobu, Naoki Yamanaka, Department of Surgery, Meiwa General Hospital, Hyogo 663-8186, Japan
Masahiro Kawanaka, Department of Internal Medicine, Meiwa General Hospital, Hyogo 663-8186, Japan
Ayako Sugihara, Department of Pathology, Meiwa General Hospital, Hyogo 663-8186, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Shin-ichi Ikuta, Department of Surgery, Meiwa General Hospital, Agenaruo 4-31, Nishinomiya, Hyogo 663-8186, Japan. ikuta@meiwa-hospital.com
Telephone: +81-798-471767 Fax: +81-798-477613
Received: May 15, 2007
Revised: June 2, 2007
Accepted: June 9, 2007
Published online: September 14, 2007
Abstract

Watery diarrhea, hypokalemia and achlorhydria (WDHA) syndrome caused by vasoactive intestinal polypeptide (VIP) -producing tumor only rarely occurs in patients with nonpancreatic disease. A 49-year-old woman was referred for evaluation of a right adrenal tumor incidentally diagnosed by abdominal ultrasound during the investigation of chronic watery diarrhea. Laboratory findings showed hypokalemia and excessive production of VIP and catecholamines. After surgical resection of the tumor, diarrhea subsided and both electrolytes and affected hormone levels normalized. Immunohistochemical examination confirmed a diagnosis of pheochromocytoma, which contained VIP-positive ganglion-like cells. We herein present the clinical and histogenetic implications of this rare clinical entity, with literature review.

Keywords: Pheochromocytoma, Vasoactive intestinal polypeptide, Watery diarrhea, hypokalemia and achlorhydria syndrome