Continuous Cervical Epidual Anesthesia in a Patient Suffering from a Severe Pain Caused by Pancoast Tumor: Case Report

Abstract

Pancoast tumor is a relatively rare form of non-small cell lung cancer. Due to its invasion of the brachial plexus, it often causes severe pain and sometimes it is difficult to control the pain. Radiotherapy is often chosen not only for the treatment of the cancer but also for pain relief in Pancoast tumors. However, radiotherapy requires the patient to be kept in a resting supine position, which can cause severe pain during treatment or make it impossible to continue treatment due to pain. In this article, we report our experience with a patient who presented with severe pain in the shoulder and upper extremities due to a Pancoast tumor. Although patient had difficulty in maintaining a resting supine position, continuous cervical epidural anesthesia enabled him to complete radiotherapy under pain control. Despite the risk of infection and bleeding from catheterization, it is important to consider the indication of continuous epidural anesthesia when pain control is poor.