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Objective: The objective of this manuscript is to report a 66-year-old female patient whose medical management for advanced stage high-grade serous carcinoma of the ovary (Ca-ovary) might have treated concomitant papillary thyroid carcinoma (PTC) diagnosed by fine needle aspiration. Methods: Patient evaluation and management consisted of positron emission tomography (PET) scans, thyroid ultrasound(s), fine needle aspiration biopsy, and thyroid function tests. Results: A 66-year-old woman presented to the endocrinology clinic while undergoing treatment for Ca-ovary with a PET scan revealing increased uptake in the thyroid gland. Due to the PET scan findings, she underwent a thyroid ultrasound examination which revealed co-existent multinodular goiter and a lesion with concerning features. Fine needle aspiration biopsy was read as PTC. Surgical intervention for PTC was delayed due to progression of the ovarian cancer. In the interim, she underwent chemotherapy with a regimen consisting of: elesclomol, paclitaxel, pemetrexed (Alimta), carboplatin, gemcitabine (Gemazar), and bevacizumab (Avastin) at varying intervals. After the patient was able to complete near total thyroidectomy, surgical pathology revealed no viable malignancy. Conclusions: We postulate that the patient’s treatment for Ca-ovary, namely pemetrexed (Alimta) and bevacizumab (Avastin) had anti-neoplastic effect against the PTC. These agents are not currently recommended treatment modalities for PTC. This hypothesis should be validated with further studies.

Objective: Octreotide three times daily is reported to reduce daily insulin by 50% in patients with Type 1 DM. Therefore, we assessed the impact of long acting Octreotide (Sandostatin LAR) monthly intramuscular administration in a subject with Type 1 DM. Methods: A 32-year-old man with Type 1 DM of 16 years participated after obtaining informed consent. He had no microvascular or macrovascular complications. He continued the present insulin regimen for four weeks. IM Sandostatin LAR 20 mg was initiated and increased at four weeks to 30 mg. He was followed every four weeks for six months. Insulin regimen was adjusted every one to two weeks based on blood glucose before meals, bedtime and on onset of hypoglycemic symptoms. He continued other medications, previous diet and activity. Assessment of HbA1c, serum electrolytes, urea nitrogen, creatinine, TSH, free T4, liver enzymes, complete blood cell counts, vitamin B12, lipids and insulin regimen were performed at the initiation and end of the study. Results: HbA1c declined from 9 to 8% with reduction in daily insulin dose from 55 to 43 units, with a major reduction in insulin Glargine, 50 to 40 units. Body weight remained unaltered. Other laboratory tests including gallbladder examination remained unchanged Conclusion: Monthly Sandostatin LAR administration may improve glycemic control with less insulin in Type 1 DM.