ABSTRACT
This study examined the effects of intrathecal analgesia (ITA) using an extracorporeal pump with a subcutaneous port system in cancer patients with bone metastasis. Among the patients who died of cancer with bone metastasis at the palliative care unit of our institution, 11 who received ITA were selected. Changes in pain, opioid doses, the palliative prognostic index (PPI), and Eastern Cooperative Oncology Group Performance Scaleãafter ITA were assessed. Pain, opioid doses, and PPI decreased after ITA (P = 0.002, 0.002, and 0.017). ITA for cancer patients with increased PPI due to refractory cancer bone pain decreased pain, opioid doses, and PPI.(100 words).
Subject(s)
Analgesics, Opioid , Bone Neoplasms , Cancer Pain , Injections, Spinal , Pain, Intractable , Palliative Care , Humans , Bone Neoplasms/secondary , Bone Neoplasms/complications , Palliative Care/methods , Cancer Pain/drug therapy , Male , Female , Injections, Spinal/methods , Middle Aged , Analgesics, Opioid/administration & dosage , Aged , Pain, Intractable/drug therapy , Pain Measurement/methods , Pain Measurement/drug effects , Analgesia/methods , Pain Management/methods , Aged, 80 and overABSTRACT
A 69-year-old woman presented with a 2-year history of an eczematous lesion covering the genital area. Histopathological examination showed deposits of amorphous, eosinophilic material and an infiltrate of plasma cells through the entire dermis into the subcutaneous fatty tissue. Congo red-stained deposits showed apple-green birefringence with polarizing microscopy. On immunohistochemistry, the deposited material was positively stained with anti-lambda light chain antibodies but not with anti-lambda light chain. A diagnosis of primary localized cutaneous amyloidosis (PLCA) was made, and the patient was also diagnosed as having Sjögren's syndrome (SjS) based on clinical and laboratory findings. The lesion of PLCA has spontaneously regressed over a period of 18 months. We report a unique case of PLCA and SjS that clinically demonstrated genital eczematous features and spontaneous involution, and we also describe a possible association between PLCA and SjS.
