Effects of octreotide in a patient with parathyroid carcinoma

Parathyroid carcinoma (PC) is a rare endocrine tumor whose management is di fficult whenever surgery does not achieve complete en bloc resection or rec urrence is detected. Medical options (mainly bisphosphonates) are scanty an d often associated with toxic side-effects. We present a case report of a p atient with recurrent PC after two surgical interventions who was treated w ith octreotide (SMS-201) taken into account the positive somatostatin stain ing of the specimen obtained during the last surgery. Short term effects (- 2 weeks-) included a decrease in urinary calcium excretion paired with a si multaneous increase in urinary phosphorus excretion. Later on, continuous s ubcutaneous octreotide administration kept urinary calcium excretion at low levels and this effect was completely reversible/reinducible upon disconti nuation/reintroduction of the drug. Neither iPTH nor total serum calcium we re modified at short or long term basis. The lack of clear-cut therapeutic effects make this findings a pure clinical observation. Thus, octreotide ca nnot be recommended for the treatment of parathyroid carcinoma.