Two patients have been studied with a two and a half and nine year history of metastatic pancreatic apudoma. In both patients the main feature was chronic watery diarrhoea with remissions after partial tumour resection and streptozotocin therapy. Plasma levels of circulating VIP and neurotensin were persistently raised in both patients. Chromatographic analysis of the plasma showed that a significant proportion of the raised immunoreactivity of both peptides eluted in an identical position to pure VIP and neurotensin. The extremely high concentrations of neurotensin did not appear to result in any feature which would allow distinction from the classical VIPoma syndrome.
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