Refractory Cancer Pain In Stage IV Atypical Lung Carcinoid

Proposal Number:


Proposal Type:

Medically Challenging Case Report Poster 


Daniel Delaney  
Mayo Clinic


Halena M. Gazelka  
Mayo Clinic


Cancer related pain that does not respond to medical treatment following the WHO guidelines is rare, and estimated to be present in only 14% of cases. Most cases of treatment refractory pain respond well to therapy with intrathecal drug delivery systems. Carcinoid tumors specifically have been shown to respond well to subcutaneous octreotide. We report a 59-year-old male with Stage IV atypical lung carcinoid with metastases to lymph nodes and bones who develops significant treatment refractory pain. The patient elected palliative sedation in the final days of life due to inadequate pain control. Treatment of refractory pain and opioid induced hyperalgesia are discussed.

Professional Category:



Pain Management

Enter up to two references.

1. Kvols, Larry K., et al. "Treatment of the malignant carcinoid syndrome." New England Journal of Medicine 315.11 (1986): 663-666.
2. Smith, Thomas J., and Patrick J. Coyne. "Implantable drug delivery systems (IDDS) after failure of comprehensive medical management (CMM) can palliate symptoms in the most refractory cancer pain patients." Journal of palliative medicine 8.4 (2005): 736-742.