A Case of Refractory Cancer-related Neuropathic-pain Caused by Intracranial Invasion of Left Nasal Cavity Carcinoma Successfully Treated with Goreisan
- VernacularTitle:左鼻腔がん頭蓋内浸潤に起因する難治性がん性神経障害性疼痛に対し，五苓散が症状緩和に有効だった一例
- Author:
Takako IKEGAMI
1
;
Naho MATSUBARA
1
;
Ayaka ISHIKAWA
1
;
Naruaki KAWASAKI
1
;
Sayaka ARAKAWA
1
;
Hiroto ISHIKI
1
;
Mai ITOYAMA
2
;
Kazuki YOKOYAMA
2
;
Eriko SATOMI
1
Author Information
- Keywords: Goreisan; cancer pain; neuropathic pain; intracranial tumor
- From:Palliative Care Research 2024;19(3):175-180
- CountryJapan
- Language:Japanese
- Abstract: Introduction: Intracranial tumors cause various neurological symptoms and neuropathic pain, which are often refractory to opioids. In some of these cases, the combination of Kampo medicines can be effective. Case: The case was a 44-year-old patient who underwent surgery for a suspected papilloma. After resection, pathological examination revealed squamous cell carcinoma, positive for margins, and then, the left intraorbital metastasis was observed. Due to the intracranial invasion of the tumor, he had pain in the second and third branches of the trigeminal nerve in the left face and paresthesia in the second branch of the trigeminal nerve bilaterally (Numerical Rating Scale: NRS 10/10). Hydromorphone was introduced, and the pain was relieved, but the paresthesia remained (NRS 8/10). Both paresthesia and pain worsened during the course of chemotherapy, but MRI showed no tumor progression, thus, the cause of symptom aggravation was diagnosed edema of the tissue around the tumor. Therefore, Goreisan was started, and both paresthesia and pain were relieved. Discussion: Goreisan has been shown to be effective in cerebral edema due to its water-regulating effect by inhibiting aquaporin. In the present case, the reduction of edema in peritumoral tissues by Goreisan may have contributed to the symptomatic relief.
