Palliative treatment of painful bone metastases from non-Hodgkin lymphoma with disodium pamidronate.

We report a case of a 72-year-old male, with a known history of non-Hodgkin lymphoma of the left tonsil for two years, histologically proved and successfully treated by radical surgical excision in combination with external radiotherapy. He presented with diffuse bone pain the last month, especially at the lower left ribs, which was found to be due to multiple osseous metastases by bone scintigraphy. The patient was initially treated by common analgesics and when the pain deteriorated he was administered 180 mg i.v. disodium pamidronate (AREDIA, Novartis Inc.). The patient showed excellent pain relief as well as dramatically improvement of WHO status and stopped the analgesics. An interesting point of our case was that the pain deteriorated again after a month and reduced soon after the re-administration of pamidronate, which was continued every month. So far, 10 months after the first pamidronate injection, our patient remains stable with excellent pain relief. Despite the absence of related data in the current literature, we consider the use of high dose pamidronate intravenous therapy safe and an effective method of palliative management of painful osseous metastases from non-Hodgkin lymphoma.