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Positron emission tomography-fluorodeoxyglucose revealed bilateral axillary and cervical lymphadenopathy as well as increased uptake in the lateral regions of both breasts. These results correlated with MRI breast and mammography findings. Axillary lymph node biopsy showed poorly differentiated adenocarcinoma making the diagnosis of breast malignancy, the most likely primary site of metastatic leptomeningeal disease. In the 6-week interval between initial presentation and diagnosis, the patient deteriorated significantly with the new onset of facial nerve palsy and partial seizures. The treatment intent was palliative, focusing on symptom control with systemic chemotherapy and whole brain radiotherapy.<\/jats:p>","DOI":"10.1136\/bcr-2014-207643","type":"journal-article","created":{"date-parts":[[2015,5,6]],"date-time":"2015-05-06T06:50:43Z","timestamp":1430895043000},"page":"bcr2014207643","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Headache in a young woman: leptomeningeal metastasis as the first presentation of underlying breast malignancy"],"prefix":"10.1136","volume":"2015","author":[{"given":"Poornima","family":"Mohan","sequence":"first","affiliation":[{"name":"Department of Acute Medicine, Hillingdon Hospital, Uxbridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilina","family":"Antonelou","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hillingdon Hospital, Uxbridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ophelia","family":"Dadzie","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Hillingdon Hospital, Uxbridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Dubrey","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hillingdon Hospital, Uxbridge, Middlesex, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,5,6]]},"reference":[{"key":"2025082700292480000_2015.may06_1.bcr2014207643.1","first-page":"561475","article-title":"Three cases of neoplastic meningitis initially diagnosed with infectious meningitis in emergency department","volume":"2013","author":"Ahn","year":"2013","journal-title":"Case Rep Emerg Med"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.3122\/jabfm.17.4.303","article-title":"Recurrent herpes simplex type 2 virus (Mollaret meningitis)","volume":"17","author":"Mirakhur","year":"2004","journal-title":"J Am Board Fam Med"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-007-9340-4"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.4","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.6.7.1115"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.5","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-001-0073-x"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.6","first-page":"85","article-title":"Leptomeningeal metastases form solid malignancy: a review","volume":"75","author":"Tailibert","year":"2005","journal-title":"J Neurol"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.7","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1255220"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.8","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23088"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.9","doi-asserted-by":"crossref","first-page":"3030313","DOI":"10.1007\/s11060-011-0664-8","article-title":"Clinical outcome of central nervous system metastases from breast cancer: differences in survival depending on systemic treatment","volume":"106","author":"Kim","year":"2012","journal-title":"J Neuro Oncol"},{"key":"2025082700292480000_2015.may06_1.bcr2014207643.10","unstructured":"Posner JB . 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