Dear Editor, Cancer pain is still a major issue despite the World Health Organization ladder. Up to 30% of the patients experience poor pain control, especially at late stages and during the last year of life [1]. While opioids are the gold standard for treatment of moderate to severe cancer pain, at least 10–15% may benefit from interventional procedures [2,3]. The main reason to advocate interventional pain management (IPM) is either a lack of efficacy of the opioids and the co-adjuvant therapy or intolerable side effects of such therapy. IPM includes neurolytic procedures (celiac plexus neurolysis, superior hypogastric neurolysis, and impar ganglion neurolysis), continuous epidural and intrathecal analgesia radiofrequency, and vertebral or bone cement augmentation [4]. Most of the IPM experience has been done on adult population, and the information in pediatric population is limited. Neurolytic injection on the impar ganglion is reported since 1990. This ganglion is a single retroperitoneal structure, marking the end of the paired paravertebral sympathetic chains. It is responsible for visceral-perineal pain that is sympathetically maintained [5]. There are no reports of neurolytic impar ganglion injection in …