Correspondence Hallucinations in an elderly cancer patient: opioid

Some clinical signs of concurrent diseases occurring in elderly cancer patients are difficult to distinguish from complications of treatments used to control cancer symptoms in palliative care. We present the case of a cancer patient with persistent visual hallucinations, ini-tially attributed to opioids, and finally diagnosed as a probable dementia with Lewy bodies. Case history A 76-year-old man with invasive bladder carcinoma was admitted to our Palliative Care Unit with severe uncontrolled pain and persistent visual hallucinations of people and complex scenes. At the time of admission, he was under treatment with transdermal fentanyl 75 ·g/h, ibuprofen 600 mg tid, and laxatives. He had moderate pain in the dorsal spine at rest, which increased with movement. His family told us abou