PALLIATION OF INTRACTABLE CANCER PAIN BY MRI-GUIDED CINGULOTOMY

Case Report: Three cases of intractable pain arising from widespread m etastatic cancer with poor response to opioids were treated with MRT-g uided cingulotomy. Results and Conclusions: In most cases, MRI-guided cingulotomy was associated with significant pain relief and reduced op ioid use. To provide insight into the role of MRI-guided cingulotomy i n oncologic pain refractory to more conservative measures, the relativ e risks and benefits of cingulotomy are discussed, along with the cour se of one patient who experienced postoperative cognitive impairment. This report also describes the relevant neurosurgical and pharmacother apeutic issues associated with management of pain in patients with wid espread metastatic disease.