• Yasuhiro Arakawa, Daisuke Inoue, Toshikazu Sakuyama, Eijiro Nagasaki, and Keisuke Aiba.
• Dept. of Oncology and Hematology, Jikei University School of Medicine.
• Gan To Kagaku Ryoho. 2011 Dec 1; 38 Suppl 1: 59-60.

AbstractWe 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.

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