[Strontium-89 therapy and subarachnoid phenol block successfully eliminated intractable pain of metastasis in the patient with advanced urachal carcinoma].

Abstract

We report a case of a 39-year-old man with intractable multifocal pain caused by metastatic urachal carcinoma to the bone. The patient underwent a partial cystectomy in May 2008, and lung metastasis occurred 9 months after the surgery. He then received salvage chemotherapy, but developed metastasis to the liver, brain, and bone. He was hospitalized due to a shoulder pain, a lower back pain, buttocks pain, numbness in both legs, and drop foot in right leg. MRI revealed metastases to the spine, and lumbar spinal canal stenosis with cauda equina compression. Even a combination of fentanyl-patch, oral acetaminophen, gabapentin and paroxetine was not effective for pain control. Strontium-89 therapy and subarachnoid phenol block successfully eliminated intractable pain. The patient could be discharged from hospital and received a palliative care at home for a short period of time.

• Authors: Yasuhiro Arakawa, Daisuke Inoue, Toshikazu Sakuyama, Eijiro Nagasaki, Keisuke Aiba
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 38 Suppl 1 Pg. 59-60 (Dec 2011) ISSN: 0385-0684 [Print] Japan
• PMID: 22189321 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Strontium Radioisotopes
• Phenol

Topics

• Adult
• Bone Neoplasms (complications, secondary)
• Humans
• Magnetic Resonance Imaging
• Male
• Pain, Intractable (drug therapy, etiology)
• Phenol (administration & dosage, therapeutic use)
• Strontium Radioisotopes (administration & dosage, therapeutic use)
• Subarachnoid Space
• Urinary Bladder Neoplasms (pathology)