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VIPoma
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     To the Editor: Lubinski and Hendrix (Aug. 19 issue)1 provide interesting images of a VIPoma. They report hypercalcemia (serum calcium level, 12.1 mg per deciliter [3.0 mmol per liter]) in the patient but do not provide any information regarding the cause. Rarely, hypercalcemia in this setting could indicate the presence of multiple endocrine neoplasia type 12 and, consequently, the need for genetic screening. Cosecretion of calcitonin by the neuroendocrine tumor of the pancreas is another possibility.3

    Biswa M. Mishra, M.D.

    Christie Hospital

    Manchester M20 4BX, United Kingdom

    biswa.mishra@christie-tr.nwest.nhs.uk

    References

    Lubinski SM, Hendrix T. VIPoma. N Engl J Med 2004;351:808-808.

    Cesani F, Ernst R, Walser E, Villanueva-Meyer J. Tc-99m sestamibi imaging of a pancreatic VIPoma and parathyroid adenoma in a patient with multiple type I endocrine neoplasia. Clin Nucl Med 1994;19:532-534.

    Ichimura T, Kondo S, Okushiba S, Morikawa T, Katoh H. A calcitonin and vasoactive intestinal peptide-producing pancreatic endocrine tumor associated with the WDHA syndrome. Int J Gastrointest Cancer 2003;33:99-102.