Difficulty Diagnosing a Brain Tumor during Clinical Maintenance of a Complete Response to anti-HER2 Treatments for Metastatic Breast Cancer: A Case Report

A 46-year-old woman with erythema of the right breast presented to our hospital and was diagnosed with stage IV breast cancer (HER2-positive invasive ductal carcinoma). She received 4 courses of anthracycline-based regimens and 4 courses of trastuzumab + pertuzumab + docetaxel (Tmab + Pmab + DTX). S...

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Bibliographic Details
Published in:Case reports in oncology 2020-10, Vol.13 (3), p.1311-1316
Main Authors: Semba, Ryoko, Horimoto, Yoshiya, Arakawa, Atsushi, Edahiro, Yoko, Takaku, Tomoiku, Iijima, Kotaro, Saito, Mitsue
Format: Article
Language:English
Subjects:
advanced breast cancer
Biopsy
Brain cancer
brain tumor
Breast cancer
Cancer therapies
Case Report
Case reports
diffuse large b-cell lymphoma of central nervous system
Immunotherapy
Lymphoma
Magnetic resonance imaging
Medical diagnosis
Medical imaging
Medical prognosis
Metastasis
Monoclonal antibodies
Nervous system
pathology
Patients
Targeted cancer therapy
Tomography
Ultrasonic imaging
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Summary:A 46-year-old woman with erythema of the right breast presented to our hospital and was diagnosed with stage IV breast cancer (HER2-positive invasive ductal carcinoma). She received 4 courses of anthracycline-based regimens and 4 courses of trastuzumab + pertuzumab + docetaxel (Tmab + Pmab + DTX). Since she responded well to these therapies, only Tmab + Pmab was continued thereafter. Twenty-three months after starting treatment, she developed a headache. A tumor was identified in the right temporal lobe. Craniotomy was performed for definitive diagnosis. Intraoperative pathological assessment suggested the tumor to be brain metastasis of breast cancer. However, the final pathological diagnosis was diffuse large B-cell lymphoma of central nervous system (DLBCL-CNS) based on re-assessment with immunohistochemical examinations. Therefore, the Tmab + Pmab was discontinued, and 6 courses of high-dose methotrexate therapy were administered. This case highlights the importance of considering rare entities, such as DLBCL, when diagnosing a solitary brain tumor in a patient with a primary cancer, based on imaging and pathological findings.
ISSN:1662-6575
1662-6575
DOI:10.1159/000511051