Skip Navigation LinksHome > November 2013 - Volume 29 - Issue 11 > Ritodrine for Intractable Uterine Pain Due to Extrapelvic Ma...
Clinical Journal of Pain:
doi: 10.1097/AJP.0b013e31828c4c13
Online Articles: Case Reports

Ritodrine for Intractable Uterine Pain Due to Extrapelvic Malignant Tumor Metastases: A Case Report

Sugiura, Yasoo MD*; Nemoto, Etsuo MD, PhD*; Kadohira, Ikuko MD, PhD; Kaseda, Shizuka MD, PhD*

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Background: Effective pain management is an essential component of cancer treatment as approximately 75% of all cancer patients experience excruciating nociceptive pain even at maximum safe doses of nonsteroidal anti-inflammatory drugs and/or opioids. We report a case where ritodrine hydrochloride effectively controlled refractory pain due to uterine metastases from thymic carcinoma.

Case presentation: A 40-year-old woman presented at our hospital with chest discomfort, severe right femoral pain, and intermittent hypogastralgia. Computed tomography, magnetic resonance imaging, and positron emission tomography revealed a large mass in the anterior mediastinum, multiple nodules in the lungs, and multiple metastases on the uterus, lumbar vertebrae, and pelvic bones. Needle biopsies of the mediastinal and uterine cervical tumors revealed undifferentiated carcinoma of the thymus metastasizing to the uterus. Oxycodone and nonsteroidal anti-inflammatory drugs relieved the right femoral pain but not the hypogastralgia. We speculated that hypogastralgia did not result from somatalgia but from splanchnodynia. Ritodrine was administered in an effort to inhibit uterine contractions and to reduced the refractory pain and improved her quality of life.

Conclusion: Ritodrine relieved the pain caused by uterine contraction due to metastases and enhanced the quality of life.

© 2013 by Lippincott Williams & Wilkins

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