Kim Young Sung, Cho Seung Inn, Lee Kuen Su, Choi Sang Sik
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, , Korea.
Department of Anesthesiology and Pain Medicine, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea.
Anesth Pain Med (Seoul). 2025 Jul;20(3):246-251. doi: 10.17085/apm.24155. Epub 2025 Jul 23.
The clinical manifestations of metastatic brachial plexopathy include pain, sensory loss, paresthesia, weakness, and reduced range of motion. These symptoms closely resemble those of shoulder disorders and peripheral nerve entrapment, which are commonly diagnosed in pain clinics, increasing the risk of misdiagnosis or delayed diagnosis, particularly in patients with a history of malignancy.
A 51-year-old woman with a history of breast cancer in complete remission for 19 years presented with shoulder pain, arm weakness, and tingling in the fingers. Initial treatments for suspected cervical radiculopathy, shoulder disorders, and nerve entrapment were ineffective. Electromyography and nerve conduction studies revealed electrophysiological abnormalities consistent with left brachial plexopathy. Magnetic resonance imaging of the brachial plexus confirmed metastatic involvement. The patient is currently undergoing chemotherapy.
Clinicians must be vigilant of the possibility of malignancy in patients with a history of cancer and should pursue comprehensive diagnostic evaluations to exclude cancer recurrence.
转移性臂丛神经病变的临床表现包括疼痛、感觉丧失、感觉异常、无力以及活动范围减小。这些症状与肩部疾病和周围神经卡压的症状极为相似，而肩部疾病和周围神经卡压在疼痛诊所较为常见，这增加了误诊或延迟诊断的风险，尤其是在有恶性肿瘤病史的患者中。
一名51岁女性，乳腺癌病史，已完全缓解19年，现出现肩部疼痛、手臂无力和手指刺痛。针对疑似颈椎病、肩部疾病和神经卡压的初始治疗均无效。肌电图和神经传导研究显示与左臂丛神经病变一致的电生理异常。臂丛神经的磁共振成像证实有转移累及。该患者目前正在接受化疗。
临床医生必须警惕有癌症病史患者发生恶性肿瘤的可能性，并应进行全面的诊断评估以排除癌症复发。
