診断が遅れたがん性髄膜炎の1症例

  • 小原 洋昭
    福井社会保険病院麻酔科 福井社会保険病院麻酔科
  • 田畑 麻里
    福井大学医学部麻酔科蘇生科 福井大学医学部麻酔科蘇生科
  • 有島 英孝
    福井大学医学部脳脊髄神経外科 福井大学医学部脳脊髄神経外科
  • 廣瀬 宗孝
    草津総合病院麻酔科 草津総合病院麻酔科

書誌事項

タイトル別名
  • A case of carcinomatous meningitis that was difficult to diagnose
  • ショウレイ シンダン ガ オクレタ ガンセイ ズイマクエン ノ 1 ショウレイ

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抄録

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.

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