{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T22:16:16Z","timestamp":1740176176146,"version":"3.37.3"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Anal and perineum pain caused by malignant tumor invasion is often difficult to control with opioids. Continuous sacral epidural ethanol injection therapy is less likely to cause bladder and rectal disturbances, making it a suitable treatment option for patients with preserved voiding function.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 45-year-old woman with multiple metastases of malignant pheochromocytoma suffered severe anal pain that worsened, especially when sitting, and was unresponsive to opioid rescue therapy.\n<\/jats:p>\n                <jats:p>With her NRS score of 9, a sacral epidural catheter was placed, and a continuous infusion of 2% lidocaine was administered overnight. This is followed by a 1.5mL bolus of ethanol and continuous ethanol administration at 2\u00a0mL\/h. After administration, her anal pain decreased to approximately NRS 0\u20131, and she was subsequently discharged.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We report successful pain control using continuous sacral epidural ethanol injection therapy in a patient with anal pain due to malignant pheochromocytoma metastasis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40981-024-00760-x","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T12:04:31Z","timestamp":1734523471000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful analgesic treatment with continuous sacral epidural ethanol injection therapy for anal pain caused by multiple metastases of malignant pheochromocytoma"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5025-4250","authenticated-orcid":false,"given":"Takehito","family":"Sato","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeru","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiko","family":"Asano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Ando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuyuki","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"760_CR1","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/s1521-6896(03)00016-8","volume":"17","author":"K Candido","year":"2003","unstructured":"Candido K, Stevens RA. Intrathecal neurolytic blocks for the relief of cancer pain. Best Pract Res Clin Anaesthesiol. 2003;17:407\u201328. https:\/\/doi.org\/10.1016\/s1521-6896(03)00016-8.","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"760_CR2","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1007\/s11916-022-01072-4","volume":"26","author":"C Wie","year":"2022","unstructured":"Wie C, Ghanavatian S, Pew S, Kim A, Strand N, Freeman J, et al. Interventional treatment modalities for chronic abdominal and pelvic visceral pain. Curr Pain Headache Rep. 2022;26:683\u201391. https:\/\/doi.org\/10.1007\/s11916-022-01072-4.","journal-title":"Curr Pain Headache Rep"},{"key":"760_CR3","first-page":"752","volume":"18","author":"M Yamamuro","year":"1997","unstructured":"Yamamuro M. Caudal block by continuous injection of alcohol for anal pain due to malignant tumor. Pain Clinic (in Japanese). 1997;18:752\u20137.","journal-title":"Pain Clinic (in Japanese)"},{"key":"760_CR4","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1016\/j.amjsurg.2010.04.012","volume":"201","author":"A Harari","year":"2011","unstructured":"Harari A, Inabnet WB 3rd. Malignant pheochromocytoma: a review. Am J Surg. 2011;201:700\u20138. https:\/\/doi.org\/10.1016\/j.amjsurg.2010.04.012.","journal-title":"Am J Surg"},{"key":"760_CR5","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/S0304-3959(01)00324-4","volume":"93","author":"T Meuser","year":"2001","unstructured":"Meuser T, Pietruck C, Radbruch L, Stute P, Lehmann KA, Grond S. Symptoms during cancer pain treatment following WHO-guidelines: a longitudinal follow-up study of symptom prevalence, severity and etiology. Pain. 2001;93:247\u201357. https:\/\/doi.org\/10.1016\/S0304-3959(01)00324-4.","journal-title":"Pain"},{"key":"760_CR6","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s11916-017-0613-0","volume":"21","author":"KD Candido","year":"2017","unstructured":"Candido KD, Kusper TM, Knezevic NN. New cancer pain treatment options. Curr Pain Headache Rep. 2017;21:12. https:\/\/doi.org\/10.1007\/s11916-017-0613-0.","journal-title":"Curr Pain Headache Rep"},{"doi-asserted-by":"publisher","unstructured":"Fumi\u0107 Dunki\u0107 L, Hosti\u0107 V, Kustura A. Palliative treatment of intractable cancer pain. Acta Clin Croat. 2022;61;Suppl 2:109\u201314. https:\/\/doi.org\/10.20471\/acc.2022.61.s2.14.","key":"760_CR7","DOI":"10.20471\/acc.2022.61.s2.14"},{"key":"760_CR8","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1097\/00000542-198812000-00038","volume":"69","author":"WC Korevaar","year":"1988","unstructured":"Korevaar WC. Transcatheter thoracic epidural neurolysis using ethyl alcohol. Anesthesiology. 1988;69:989\u201393. https:\/\/doi.org\/10.1097\/00000542-198812000-00038.","journal-title":"Anesthesiology"},{"key":"760_CR9","first-page":"299","volume":"44","author":"T Noguchi","year":"2023","unstructured":"Noguchi T, Konno M, Ito M, Kudo R, Kimura H, Hirota K. A case of epidural alcohol block in end-stage anorectal cancer pain. Pain Clinic (In Japanese). 2023;44:299\u2013301.","journal-title":"Pain Clinic (In Japanese)"},{"key":"760_CR10","doi-asserted-by":"publisher","first-page":"137","DOI":"10.2512\/jspm.18.137","volume":"18","author":"N Matsumoto","year":"2023","unstructured":"Matsumoto N, Fukunaga T, Monma K, Murata Y, Okabe D, Ishikawa S. Neurolytic caudal epidural block for rectal tenesmus: a case report. Palliat Care Res (In Japanese). 2023;18:137\u201341. https:\/\/doi.org\/10.2512\/jspm.18.137.","journal-title":"Palliat Care Res (In Japanese)"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-024-00760-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-024-00760-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-024-00760-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T13:11:48Z","timestamp":1734527508000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-024-00760-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,18]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["760"],"URL":"https:\/\/doi.org\/10.1186\/s40981-024-00760-x","relation":{},"ISSN":["2363-9024"],"issn-type":[{"type":"electronic","value":"2363-9024"}],"subject":[],"published":{"date-parts":[[2024,12,18]]},"assertion":[{"value":"31 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We have applied to our affiliated institution for approval of the off-label use of continuous sacral epidural block with absolute ethanol (approval number: TF10013).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient and family for the publication of this case report and the images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"75"}}