[Effects of octreotide on serum and urine electrolytes in a patient with parathyroid carcinoma: clinical case]

Author(s): Ybarra J, Moises J, Torregrosa JV, Madhun ZT, Schumacher OP

Affiliation(s): Unidad de Trasplante Renal Hospital Clinic 08036 Barcelona.

Publication date & source: 2001-07, Nefrologia., 21(4):406-10.

Publication type: Case Reports

Parathyroid carcinoma (PC) is a rare endocrine tumor whose management is difficult whenever surgery does not achieve complete en bloc resection or recurrence is detected. Medical options (mainly bisphosphonates) are scanty and often associated with toxic side-effects. We present a case report of a patient with recurrent PC after two surgical interventions who was treated with octreotide (SMS-201) taken into account the positive somatostatin staining of the specimen obtained during the last surgery. Short term effects (-2 weeks-) included a decrease in urinary calcium excretion paired with a simultaneous increase in urinary phosphorus excretion. Later on, continuous subcutaneous octreotide administration kept urinary calcium excretion at low levels and this effect was completely reversible/reinducible upon discontinuation/reintroduction of the drug. Neither iPTH nor total serum calcium were modified at short or long term basis. The lack of clear-cut therapeutic effects make this findings a pure clinical observation. Thus, octreotide cannot be recommended for the treatment of parathyroid carcinoma.