Malignancy in patients with opioid use disorder: A late diagnosis in patient on maintenance treatment with Buprenorphine, with lethal effect: a case report

Abstract

Heroin dependents might be at a higher risk of death from cancer than the general population. A 31-year-old male on maintenance treatment with Buprenorphine, came to our Clinic with paralysis of his legs. He also complained on spinal pains. He couldn’t walk and he was in forced position. The biochemical analysis showed high values of SE, LDH, globulins, CRP, D-dimer, Tu markers: beta HCG, CYFRA 21-1, presence of paraproteins. The other investigations showed enlarged lymph nodes in the abdomen and small pelvis, thrombosis of v.cava inf and right v. iliaca. The histological finding from the biopsy of the sacrum showed a metastatic process on the skeletal muscles. The patient was treated with buprenorphine, antibiotic therapy, Carbamazepine, anticoagulant therapy and other symtomatic therapy. Despite numerous investigations and treatment, bleeding and abscesses in the cerebrum occurred. The patient immediately underwent surgery and his recovery was well. He was discharged on his request, but his condition was deteriorated sharply at home and he died in a short time. There are few studies on malignant diseases found in heroin dependents. It is a challenge to monitor and also to compare the incidence of malignancy between heroin dependents and healthy population.