@entity1820 are slowly growing and @entity3 are often limited to the liver. As a result of their favorable biological behavior these @entity5 have a relatively good prognosis even in metastatic stage. Due to a variety of therapeutic options @entity1 with @entity5 may survive for extended periods of time up to ten years. Often a combination of different treatments and also alternation between the different therapeutic regimes is needed. A @entity1 with excessive @entity11563 and severe @entity209 due to a @entity11563 with metastatic spread into the liver and abundant hormonal secretion is presented. Cytotoxic agents ( @entity3839 , @entity1487 and @entity632 ) were able to alleviate clinical symptoms and to control @entity5 growth for six years. Analogues of @entity1943 ( @entity2390 ) and interferon alpha had been very useful in controlling clinical symptoms and @entity5 progress for 18 months. Cytotoxic agents or @entity2390 were not able, however, to achieve any permanent cure. Eventually, treatment failure occurred with dramatic progression of symptoms and @entity5 growth, unresponsive to any medical therapy. Consequently, total hepatectomy and liver transplantation together with extirpation of the pancreatic @entity5 was performed and succeeded in providing a normal life to the @entity1 . In our opinion the overall outcome of @entity1 with metastatic @entity11563 may be improved best by maintaining the @entity1 on medical therapy until treatment failure occurs. In case of extended hepatic @entity3 orthotopic liver transplantation might be considered for @entity1 with symptomatic disease who no longer respond to conventional treatment modalities.

Metastatic XXXX : deteriorating clinical course and successful treatment by liver transplantation.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity632 :: ('MESH:D004317', 'Chemical') :: ['adriamycin'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignant neuroendocrine tumors', 'tumor', 'primary tumor', 'tumors'] @entity3839 :: ('MESH:D013311', 'Chemical') :: ['streptozocin'] @entity11563 :: ('MESH:D003969', 'Disease') :: ['pancreatic VIPoma', 'VIPoma', 'WDHA-syndrome'] @entity1820 :: ('MESH:D005770', 'Disease') :: ['Gastrointestinal neuroendocrine tumors'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity2390 :: ('MESH:D015282', 'Chemical') :: ['octreotide'] @entity209 :: ('MESH:D008659', 'Disease') :: ['metabolic disturbances'] @entity1943 :: ('MESH:D013004', 'Chemical') :: ['somatostatin'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['5-fluorouracil']
@entity11563 :: (MESH:D003969,Disease) :: ['pancreatic VIPoma']
