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      Importancia de la sospecha clínica del síndrome de psoas maligno en cuidados paliativos domiciliarios Translated title: Importance of the clinical suspect of malignant psoas syndrome in home palliative care

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          Abstract

          Resumen El síndrome del psoas maligno (SPM) es una entidad rara, de origen tumoral, que cursa con dolor severo al flexionar la cadera debido a la afectación metastásica del músculo psoas mayor. No existe un tratamiento específico eficaz, siendo su progresión rápidamente invalidante, lo cual dificulta el diagnóstico y ensombrece la calidad de vida y pronóstico de los enfermos.

          Translated abstract

          Abstract Malignant psoas syndrome (MPS) is a rare tumoral disease that causes severe pain when flexing the hip. The origin is a metastatic involvement of the psoas major muscle. There isn´t specific treatment and disease progression is rapidly disabling. The diagnosis is difficult and the quality of life of patients is very poor.

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          Malignant psoas syndrome: recognition of an oncologic entity.

          M. J. Stevens, Y Gonet (1990)
          From January 1985 to January 1989 four patients with advanced cancer developed a syndrome characterized by proximal lumbosacral plexopathy and painful flexion of the ipsilateral hip with positive psoas muscle stretch test. Malignant involvement of the psoas major muscle was confirmed radiologically in all cases. Pain was intractable in 3 patients until time of death. We have termed this presentation the malignant psoas syndrome (MPS) and retrospective review of 427 oncology patients with "high risk" solid cancer culled no additional cases during the same 4-year period. We believe MPS to be a hitherto unreported complication of systemic cancer in which malignant involvement of the psoas muscle, in addition to producing severe nociceptive pain, contributes to the process of lumbosacral deafferentation. The clinical presentation, diagnosis and strategies of management of MPS are discussed.
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            The management of malignant psoas syndrome: case reports and literature review

            Andrew Broadbent, Meera Agar, Richard Chye (2004)
            Malignant psoas syndrome (MPS) was first described in 1990, and is characterized by proximal lumbosacral plexopathy, painful fixed flexion of the ipsilateral hip, and radiological or pathological evidence of ipsilateral psoas major muscle malignant involvement. There have been 23 case reports of MPS in medical journals. Despite being associated with a severe and difficult pain, there is no definitive approach to management presented in the palliative care literature. We review the relevant clinical features and the subsequent multidisciplinary pain management in relation to four new cases of malignant involvement of the psoas muscle, and the 23 case reports in the literature. We propose that MPS comprises a continuum of symptoms and signs related to the degree of anatomical destruction with associated inflammatory reaction and muscle spasm, and also the degree of lumbosacral plexopathy causing neuropathic pain. A protocol is presented for the management of the complex pain issues of MPS directed at likely mechanisms. The treatment options include opioids, agents for neuropathic pain, muscle relaxants to manage psoas muscle spasm, and anti-inflammatory agents to reduce peritumoral edema. Direct anti-tumor measures also need to be considered. Further prospective study is needed to validate the proposed methods of assessment and treatment.
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              Malignant psoas syndrome associated with gynecological malignancy: Three case reports and a review of the literature.

              Shiro Takamatsu, Kosuke Murakami, Hisamitsu Takaya … (2018)
              Malignant psoas syndrome (MPS) is a rare and unique cancer-associated syndrome caused by the malignant involvement of the psoas major muscle, and is characterized by ipsilateral lumbosacral plexopathy and painful hip flexion. The pain in MPS is often distressing and intractable, and there is no established effective treatment approach. Herein, the present study reports on three cases of MPS associated with gynecological malignancies, wherein symptom improvement was observed following chemotherapy or radiotherapy. Among 39 cases documented in the literature, female genital tract malignancies were the most frequent causes of MPS; however, the condition may be under-diagnosed, owing to the lack of general recognition. Considering the development of recent high-precision radiation therapy, palliative radiotherapy may serve an important role in the management of MPS. For physicians treating gynecological cancers, early detection of MPS is clinically important as this may allow patients to receive possible therapies and improve their quality of life in end-stage cancer. Further prospective studies should be performed to evaluate effective therapeutic approaches for MPS.
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                Author and article information

                Journal
                Journal ID (publisher-id): had
                Title: Hospital a Domicilio
                Abbreviated Title: Hosp. domic.
                Publisher: Centro Internacional Virtual de Investigación en Nutrición (CIVIN) (Alicante, Alicante, Spain )
                ISSN (Electronic): 2530-5115
                Publication date (Print and electronic): June 2022
                Volume: 6
                Issue: 2
                Pages: 85-92
                Affiliations
                [1] Ponferrada orgnameHospital el Bierzo orgdiv1Unidad de Hospitalización a domicilio (UHD) España
                Article
                Publisher ID: S2530-51152022000200085 Publisher ID: S2530-5115(22)00600200085
                DOI: 10.22585/hospdomic.v6i2.158
                SO-VID: fcd1bfdb-f087-47cb-92d0-7482ec058256
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                Date received : 11 February 2022
                Date accepted : 15 March 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 8
                Product

                SciELO Spain

                Categories
                Subject: Notas clínicas

                Keywords: Dolor,Psoas Muscle,Sacral plexopathy,Hip,Pain,Músculo Psoas,Plexopatía sacra,Cadera
                Data availability:
                Keywords: Dolor, Psoas Muscle, Sacral plexopathy, Hip, Pain, Músculo Psoas, Plexopatía sacra, Cadera

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