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Medicine (Baltimore) ; 99(1): e18298, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895768


INTRODUCTION: Leptomeningeal dissemination due to HER2-overexpressing breast cancer is a rare and hard to treat complication with short-term dismal prognosis. PATIENT CONCERNS: A 34-year-old female previously treated because of HER2+ breast cancer is admitted to the Neurology Department in December 2016 due to sensory-motor neurological semiology. DIAGNOSIS: A wide set of diagnostic tests is performed and finally cytologic findings after repeated CSF confirm leptomeningeal infiltration by breast carcinoma (panCK+, GATA3+). INTERVENTIONS: Weekly intrathecal triple therapy with methotrexate, cytarabine and hydrocortisone plus trastuzumab is carried out during 4 months. OUTCOMES: Clinical and pathological response that lasts more than 24 months. CONCLUSION: Leptomeningeal carcinomatosis is an oncological situation where conventional therapies have limited activity. In HER2+ advanced breast cancer patients, intrathecal therapy with anti-HER2 therapy (trastuzumab) is feasible and may reach long-term disease control, especially in cases of low-tumor burden.

Antineoplásicos Imunológicos/uso terapêutico , Neoplasias da Mama/patologia , Carcinoma Ductal/patologia , Carcinomatose Meníngea/tratamento farmacológico , Carcinomatose Meníngea/secundário , Trastuzumab/uso terapêutico , Adulto , Neoplasias da Mama/tratamento farmacológico , Carcinoma Ductal/tratamento farmacológico , Feminino , Humanos , Carcinomatose Meníngea/patologia , Gravidez , Complicações Neoplásicas na Gravidez/tratamento farmacológico , Complicações Neoplásicas na Gravidez/patologia , Receptor ErbB-2