Vasoactive intestinal peptide (VIP)-secreting neuroblastic tumors are rare pediatric neoplasms that pose significant diagnostic and therapeutic challenges. This report presents two cases of VIP-secreting neuroblastomas presenting with chronic secretory diarrhea. The first case involved a 5-month-old infant with inoperable retroperitoneal neuroblastoma, severe malnutrition, and persistent watery diarrhea. The second case described a 27-month-old child with stage IV metastatic neuroblastoma and treatment-resistant diarrhea. Both cases emphasize the importance of early recognition, multidisciplinary management, and the challenges of treating advanced disease.
A systematic literature review from 2000-2024 identified 17 pediatric cases of VIP-secreting neuroblastic tumors presenting with chronic diarrhea, often accompanied by severe weight loss (88%) and failure to thrive (18%). Management strategies combining chemotherapy, nutritional support, and somatostatin analogs provided symptomatic relief in localized cases, but advanced-stage disease outcomes remain poor. This report underscores the need for heightened clinical awareness and timely diagnostic approaches for this rare presentation of neuroblastomas, particularly in infants and young children with unexplained secretory diarrhea.

Abdulrahman Alrifaai is a sixth-year medical student at the University of Jordan, with a strong interest in pediatrics and neonatology. His research focuses on rare pediatric conditions, including neuroblastic tumors with unique presentations. Abdulrahman has authored case reports and actively participates in medical conferences to share findings and gain insights into innovative approaches to pediatric care.