A case of primary small cell carcinoma of the larynx with persistent pain

We experienced a patient who required a high-dose opioid for pain control, a 39-year-old male who was diagnosed as having primary small cell carcinoma of the larynx. He received concurrent chemoradiotherapy with cisplatin plus etoposide, and achieved a complete response. Four months later, multiple bone and distant metastases became evident. He was treated with concurrent platinum-based chemotherapy and an opioid, NSAIDs, adjuvant analgesics, radioactive strontium and palliative radiotherapy for management of the pain associated with the bone metastases. The pain gradually became stronger, and we increased the opioid dose up to 16680 mg/day in terms of oral morphine. Finally the pain was successfully managed until his death. (author)