Successful Palliation with Octreotide of a Neuroendocrine Syndrome fomr Malignant Melanoma

We present a unique case of a neuroendocrine syndrome in a patient with Stage IV vaginal melanoma metastatic to the liver that was successfully palliated with octreotide. Similar to the carcinoid syndrome, the patient exhibited chronic diaphoresis, intermittent low-grade fevers, dizziness, nausea wi...

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Bibliographic Details
Published in:Journal of pain and symptom management 2006-08, Vol.32 (2), p.191-195
Main Authors: Jahng, Alexander W, Liao, Solomon S
Format: Article
Language:English
Subjects:
Clinical effectiveness
Drugs
Neuroendocrine response
Palliative care
Skin melanoma
Online Access:Get full text
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Summary:We present a unique case of a neuroendocrine syndrome in a patient with Stage IV vaginal melanoma metastatic to the liver that was successfully palliated with octreotide. Similar to the carcinoid syndrome, the patient exhibited chronic diaphoresis, intermittent low-grade fevers, dizziness, nausea with vomiting, & hot flashes. The symptoms on admission of acute hypotension, acute exacerbation of abdominal pains, & intractable nausea with vomiting suggested a neuroendocrine crisis secondary to massive degranulation & hormone release. Consistent with our hypothesis, her plasma chromogranin A was found to be elevated. Octreotide was used successfully to palliate her symptoms. When the octreotide was stopped, all her symptoms returned. As the use of octreotide is gaining application in palliative care, this case highlights the effectiveness of its use in a select group of patients whose symptoms would be otherwise difficult to manage. References. [Copyright 2006 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc.]
ISSN:0885-3924
DOI:10.1016/j.painsymman.2006.02.014