Abstract
Ossification of the anterior longitudinal ligament (OALL), one of the diffuse idiopathic skeletal hyperostoses, is a rheumatological abnomality in which severe ossification occurs along ligaments throughout the body. It is relatively rare, affeciting older male predominantly. The disease is usually asymptomatic but can produce nonspecific postural symptoms such as chronic back pain. We report a terminally ill pancreatic cancer patient with OALL who suffered from severe abdomined and back pain. Although the neurolytic celiac plexus block successfully reduced the upper abdominal pain and daily analgesic dose, the patient's overall activity of daily living did not improve because of persistent back pain in supine position. The postprocedural lateral spinal radiograph revealed diffuse calcification of the anterior longitudinal ligaments along the spine, that was probably responsible for his back pain. This case highlighted the importance of intense assessment of cancer-unrelated pain, including muscloskeletal components, especially in elderly cancer patients.
