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A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine

BACKGROUND: Leptomeningeal metastases (LM) pose the most difficult form of cancer metastasis to treat and portend a poor prognosis. Standard treatment has yet to be established, and intrathecal chemotherapy and whole- brain radiotherapy are administered on an empirical basis. CASE DESCRIPTION: We re...

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Autores principales: Nakao, Takayuki, Okuda, Takeshi, Fujita, Mitsugu, Kato, Amami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744731/
https://www.ncbi.nlm.nih.gov/pubmed/31528467
http://dx.doi.org/10.25259/SNI-106-2019
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author Nakao, Takayuki
Okuda, Takeshi
Fujita, Mitsugu
Kato, Amami
author_facet Nakao, Takayuki
Okuda, Takeshi
Fujita, Mitsugu
Kato, Amami
author_sort Nakao, Takayuki
collection PubMed
description BACKGROUND: Leptomeningeal metastases (LM) pose the most difficult form of cancer metastasis to treat and portend a poor prognosis. Standard treatment has yet to be established, and intrathecal chemotherapy and whole- brain radiotherapy are administered on an empirical basis. CASE DESCRIPTION: We report on a 46-year-old woman with LM from human epidermal growth factor receptor 2 (HER2)-positive breast cancer. She was suffering from intractable headaches, severe nausea and vomiting, and cerebellar ataxia. Contrast-enhanced magnetic resonance imaging (MRI) revealed diffuse enhancement of the meninges, mainly in the posterior cranial fossa, and compression of the cerebellum by the profoundly thickened meninges. The first step in the treatment was decompression of the posterior cranial fossa to relieve intracranial hypertension. After surgery, her symptoms immediately improved. The second step was treatment with lapatinib at 1250 mg and capecitabine 1200 mg, which dramatically improved her symptoms and disappeared diffuse abnormal signal enhancement on MRI. CONCLUSION: We treated a patient with LM from primary HER2-positive breast cancer who responded well to lapatinib plus capecitabine.
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spelling pubmed-67447312019-09-16 A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine Nakao, Takayuki Okuda, Takeshi Fujita, Mitsugu Kato, Amami Surg Neurol Int Case Report BACKGROUND: Leptomeningeal metastases (LM) pose the most difficult form of cancer metastasis to treat and portend a poor prognosis. Standard treatment has yet to be established, and intrathecal chemotherapy and whole- brain radiotherapy are administered on an empirical basis. CASE DESCRIPTION: We report on a 46-year-old woman with LM from human epidermal growth factor receptor 2 (HER2)-positive breast cancer. She was suffering from intractable headaches, severe nausea and vomiting, and cerebellar ataxia. Contrast-enhanced magnetic resonance imaging (MRI) revealed diffuse enhancement of the meninges, mainly in the posterior cranial fossa, and compression of the cerebellum by the profoundly thickened meninges. The first step in the treatment was decompression of the posterior cranial fossa to relieve intracranial hypertension. After surgery, her symptoms immediately improved. The second step was treatment with lapatinib at 1250 mg and capecitabine 1200 mg, which dramatically improved her symptoms and disappeared diffuse abnormal signal enhancement on MRI. CONCLUSION: We treated a patient with LM from primary HER2-positive breast cancer who responded well to lapatinib plus capecitabine. Scientific Scholar 2019-06-28 /pmc/articles/PMC6744731/ /pubmed/31528467 http://dx.doi.org/10.25259/SNI-106-2019 Text en Copyright: © 2019 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Nakao, Takayuki
Okuda, Takeshi
Fujita, Mitsugu
Kato, Amami
A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine
title A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine
title_full A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine
title_fullStr A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine
title_full_unstemmed A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine
title_short A case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine
title_sort case of leptomeningeal metastases of human epidermal growth factor receptor 2-positive breast cancer that responded well to lapatinib plus capecitabine
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744731/
https://www.ncbi.nlm.nih.gov/pubmed/31528467
http://dx.doi.org/10.25259/SNI-106-2019
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