1.Successful Treatment of Severe Lumbago in a Pediatric Renal Cancer Patient Using Implanted Epidural Analgesia: A Case Report
Miyako NODA ; Kenichi MAEKAWA ; Yuichi SASAKI ; Kei KASAMO ; Shintaro HAGIHARA ; Kei ENOHATA ; Takuro SONODA ; Tatsuro NAKAMURA ; Yuichi KODAMA ; Yasuhiro OKAMOTO ; Shinichi UENO
Palliative Care Research 2025;20(4):216-221
Introduction: Relieving cancer pain in children poses significant challenges, especially when pharmacological therapies become ineffective or difficult to administer. This case report describes a pediatric patient with renal cancer who experienced severe lumbago and was successfully treated with implanted epidural analgesia. Case: An 11-year-old boy had been diagnosed with left renal cell carcinoma 1 year prior. After a left nephrectomy and postoperative chemotherapy, the patient experienced a local recurrence a few months later. The patient was referred to the palliative care team because of discomfort in the lumbar region. Detailed imaging and medical history strongly suggested cancer-related pain. Opioid therapy was initiated; however, the patient developed increasing difficulties with oral intake due to headache and nausea associated with escalating pain levels. Epidural analgesia was administered, which resulted in pain relief and improved oral intake. Considering the child’s prognosis, a subcutaneous implantable epidural port was placed to facilitate the continuation of treatment. Subsequently, the patient’s quality of life improved, allowing for activities such as outings. Conclusion: When facing the limitations of pharmacological therapies, a nerve block such as an epidural analgesic can be an effective therapeutic option in pediatric cancer treatment.
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