Abstract
We present a case of breast cancer whose initiating symptom was painful ophthalmoplegia and had pachymeningitis. A 70-year-old female admitted because of left ocular pain and ptosis. Magnetic resonance imaging revealed pachymeningitis and contrast enhancement and thickening of left cavernous sinus. Bone marrow pathology was associated with metastatic carcinoma. Bone scintigraphy indicated diffuse metastatic activity in skeleton particularly in cranium. Painful ophthalmoplegia and pachymeningitis are thought to be associated with metastatic carcinomatosis. Primary tumor indicated infiltrating ductal cancer of breast. Clinicians should consider that metastatic breast cancer may first be presented by painful ophthalmoplegia.
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