Abstract
Meningeal dissemination from breast cancer is reportedly rare in Japan. We describe a case of meningeal dissemination with local metastases to the bilateral optic nerve after peritonitis carcinomatosa in a patient who underwent surgery for breast cancer 7 years previously. The patiet was a 60-year-old woman with left breast cancer who underwent a muscle-preserving radical mastectomy（Br+Ax）．The tumor was classified as T2N1M0Stage II B. She received 6 cycles of paclitaxel every week, after which an aromatase inhibitor（exemestane）was administered for 5 years. Right ureteral stenosis and right hydronephrosis developed 7 years and 4 months after surgery. These findigs were compatible with peritonitis carcinomatosa resulting from breast, therefore, 6 cycles of the epirubicin-cyclo-phosphamide regimen were administered, and hydronephrosis was successfully resolved. However, 6 months later, she was readmitted to our hospital presenting with a sudden headache and, vision loss in both eyes. The patient was diagnosed with meningeal carcinomatosis breast cancer by enhanced magnetic resonance imaging（MRI）and cerebrospinal fluid cytology, and she died on the seventh day after readmission. MRI also revealed local metastases to the bilateral optic nerve. Despite various interventions, most patients with meningeal dissemination from breast cancer have poor prognosis within 6 months after diagnosis.
