Intractable hypercalcemia due to a metastatic carcinoid secreting parathyroid hormone-related peptide and interleukin-6: Response to octreotide

We describe a patient with a malignant carcinoid tumor who presented with s evere, intractable hypercalcemia that would not respond to conventional the rapy with fluids and pamidronate. His plasma concentrations of parathyroid- hormone-related peptide (PTHrP) and interleukin-6 (IL-6) were elevated. The patient was treated with subcutaneous injections of octreotide with a good response, resulting in normocalcemia. Plasma PTHrP and IL-6 fell with the octreotide but remained elevated above the upper limit of normal. We conclu de that although rare, hypercalcemia may be associated with carcinoid tumor s and may be mediated through the secretion of cytokines and or PTHrP. Trea tment with octreotide may be effective in treating hypercalcemia in such pa tients.