Abstract
We report a patient with neck and shoulder pain diagnosed as carcinomatous meningitis caused by metastasis of breast cancer. A 54-year-old woman developed this pain 8 months after mastectomy. She was revealed by magnetic resonance imaging and computed tomography to have no malignancy, so we first started pain treatment. Occipital nerve block and triggerpoint injection improved her pain, but 3 weeks later, the treatments became less effective, and the pain increased in sensitivity; thus we consulted neurosurgeons. They found meningeal signs diagnosed as carcinomatous meningitis by cerebrospinal fluid examination. In a case of progressive and persistent pain, we should suspect the presence of malignancy and expect to find evidence of meningeal signs.
