Endocrine Abstracts

Somatostatin analogues (SA) represent the most effective medical treatment for the control of neuroendocrine tumour (NET) symptoms, like carcinoid syndrome. Recently there has been evidence of lengthened time to tumour progression in patients with midgut carcinoid treated with octreotide. Nevertheless, a number of new therapeutic indications and the clinical effectiveness of SA for other clinical conditions are appearing. A 69-year-old man was investigated for anaemia (haemoglobin: 8.0 g/dl). He required blood transfusion every 2–3 weeks. He had a medical history of peripheral vascular disease, coronary artery disease and by-pass graft, decreased left ventricular function, and pulmonary hypertension. Following a set of investigations, chronic digestive bleeding likely secondary to angiodysplasia was diagnosed but surgical approach was not feasible. The radiological investigations incidentally discovered abdominal and inguinal lymph node metastases and subsequent lymph node biopsy revealed metastatic NET. Unfortunately, the primary tumour remained unidentified. Treatment with long-acting octreotide was established. The need for blood transfusions dramatically decreased starting from the first month of treatment with long-acting octreotide. His haemoglobin levels improved and remained stable around 10.0 g/dl over the following 12 months. Since commencement of octreotide, he required one blood transfusion every 4–5 months only. No adverse events occurred and the patient remained stable from a NET-related point of view. To the best of our knowledge, this is the first report of a serendipitous effect on anaemia due to chronic lower digestive bleeding achieved by long-acting octreotide treatment prescribed for metastatic NET. This report is consistent with the literature reporting a potential indication of SA for the treatment of lower digestive bleeding from a known or unknown source. In our opinion, this report shows that treatment with SA in patients with lower digestive bleeding can be beneficial if the surgical approach is not feasible and only palliative therapies are available.