An Extradural Cervical Mass Mimicking Myofascial Neck Pain in an Elderly Female: A Case Report.

We detail the case of an 85‑year‑old woman with osteopenia and a history of breast cancer, who came to the Physical Medicine and Rehabilitation (PM&R) clinic complaining of ongoing neck pain without motor, sensory, or neurological deficits. After conservative management failed to provide the patient relief, magnetic resonance imaging revealed an extradural mass at the C4-C6 levels. Neurosurgical evaluation determined that the mass was likely a meningioma. Considering the patient's age, stable clinical condition, and her personal preferences, she chose to proceed with conservative management, declining both biopsy and surgical intervention. This case report aims to emphasize the importance of patient autonomy, the need for appropriate escalation of care in cases of persistent neck pain, and the principles of functional improvement and quality of life central to PM&R.