Fibrous mass complicating epidural morphine infusion

Area of Science:

• Neurology
• Oncology
• Pain Management

Background:

• Continuous epidural morphine infusion via implanted pumps is used for intractable cancer pain.
• Commonly discussed aspects include dosage, technique, pain relief, and tolerance.
• Anticipated complications involve surgical implantation and drug toxicity.

Observation:

• A rare complication potentially related to the epidural catheter itself is presented.
• A fibrous reaction developed around the catheter tip, forming a mass.
• This mass caused significant spinal cord displacement and long tract symptoms.

Findings:

• Myelography and computed tomography identified the abnormality.
• Prompt surgical decompression was performed.
• The patient's condition improved following the intervention.

Implications:

• This case highlights a previously undescribed complication of epidural catheter use.
• It underscores the importance of considering catheter-related issues in patients with implanted pump systems.
• Early diagnosis and surgical decompression are crucial for managing such complications and improving patient outcomes.