Percutaneous Cordotomy for Cancer-Associated Pain

Percutaneous cordotomy is well-established as a safe and effective treatment of cancer-associated pain. It remains a first-line treatment in countries where more expensive treatments such as implantable neurostimulators and pumps are not routinely available. We present a case report of a patient with metastatic adenocarcinoma of the esophagus and refractory right upper extremity pain, who was successfully treated via percutaneous CT-guided cordotomy. The procedure was completed in an outpatient setting; the patient was discharged after several hours, with immediate pain relief. He continued to benefit from the procedure for several months until he succumbed to his disease. The technique, decision making, complication profile, as well as the existing experience are presented and discussed in detail.