First evidence of oncologic neuropathic pain prevalence after screening 8615 cancer patients. Results of the On study.

BACKGROUND: Thirty percent to ninety percent of cancer patients suffer from pain, including neuropathic pain (NP), which results in great burden for cancer patients. Thus, it was of great interest to determine NP prevalence in cancer patients in Spain, to raise awareness of the condition, and aiming to improve management of cancer NP. PATIENTS AND METHODS: A 1-month follow-up prospective epidemiological multicenter study was conducted to assess prevalence and management of NP in Spanish oncologic units. The first 10 cancer patients at each unit diagnosed with NP by the validated Douleur Neuropathique 4 questionnaire (DN4) were recruited. RESULTS: Of 8615 screened patients, 2567 (30%) suffered from pain. From these, 33% had NP according to investigators and 19% according to DN4 test. Three hundred and sixty-six patients (mean age 62.6 years; 61.2% male) were recruited. Pain decrease at 1 month was greater in patients with metastases (P<0.01) and depended on treatment (P<0.05), with 'oxycodone' showing 50.4% pain relief. CONCLUSIONS: NP prevalence in cancer pain is 33%. DN4 reports only about half the cancer NP cases diagnosed by clinicians. Pharmaceutical treatment of cancer pain, including NP, has a greater effect in patients with metastases and seems to depend on the specific treatment used.

Pioderma gangrenoso como síndrome paraneoplásico de un adenocarcinoma de recto / Gangrenous pyoderma as paraneoplastic syndrome of an adenocarnocima of the rectum

Propósito: Los síndromes paraneoplásicos sonentidades sintomáticas provocadas por el cáncer endiversos lugares del organismo. Su incidencia estáinfraestimada y no siempre son bien conocidos. Pretendemospresentar un ejemplo de los hechos quedebe cumplir una entidad nosológica para ser consideradacomo síndrome paraneoplásico: relacióntemporal y curso evolutivo paralelo.Material y métodos: Mujer de 72 años quedebuta con una lesión cutánea finalmente diagnosticadacomo pioderma gangrenoso precediendo a unaneoplasia digestiva.Conclusiones: El tumor digestivo más frecuentementeasociado al pioderma gangrenoso es elcolorectal. Se puede afirmar que está bien establecidala existencia de esta enfermedad cutánea comosíndrome paraneoplásico

Purpose: Paraneoplastic syndromes are clinicalsyndromes caused by tumors occurring in placesdistant from the tumor itself. Its incidence isunderestimated. We present a case of paraneoplasticsyndrome as an example, indicating thecharacteristics these syndromes must follow to beconsidered as suchMaterial and methods: A 72 year oldwoman with a skin disorder diagnosed as pyodermagangraenosum before the diagnosis of a colo-rectalcancer were made.Conclusion: Colo-rectal tumors are thedigestive neoplasms more frequently associated topyoderma. The relation between pyoderma as aparaneoplastic syndrome of colo-rectal cancer iswell established

Osteosarcoma meníngeo sin exposición previa a radiaciones. A propósito de un caso / Meningeal osteosarcoma without previous exposition to radiation. About a case

Los osteosarcomas intracraneales primarios son lesiones verdaderamente infrecuentes. La radiación previa ha sido, descrita como un factor predisponente para el desarrollo de osteosarcomas meníngeos primarios. Presentamos el caso de un paciente diagnosticado de osteosarcoma meningeo primario sin exposición previa a radiaciones, tratado con cirugía, quimio y radioterapia, aprovechando para revisar el estado de la literatura al respecto. (AU)