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May 30, 1977

Dantrolene, Pelvic Neoplasm, and Muscle Spasms: Report of a Case

JAMA. 1977;237(22):2378. doi:10.1001/jama.1977.03270490018002

To the Editor.—  One of the major (and most difficult) problems faced in the treatment of patients with extensive pelvic tumors is the severe pain from sacral plexus and pelvic peripheral nerve invasion by the tumor. Another much less common but equally difficult problem is the treatment of extremely painful muscle spasms that may occur in the lower extremities from pelvic and sacral nerve invasion. In a recent case, we successfully controlled such muscle spasms.

Report of a Case.—  A 65-year-old man had advanced adenocarcinoma of the rectum. Approximately one year after diagnosis and resection of a stage II primary tumor with creation of a colostomy, pulmonary metastases and severe pelvic and perineal pain developed. Chemotherapy was unsuccessful at controlling either problem, so he received irradiation to the whole pelvis (total dose, 4,600 rads) in an effort to palliate his pain. This produced partial relief for a short time, but