Complete Cerebrospinal Fluid Response to T-DM1 in HER2 Positive Metastatic Breast Cancer - A Case Report

Sep 24, 2026

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Leptomeningeal carcinomatosis is a rare but serious consequence of existing tumors, with breast cancer representing the most frequent association. A case is described in which leptomeningeal carcinomatosis was confirmed through cerebrospinal fluid analysis despite clear brain and spinal MRI. The patient, receiving chemotherapy for advanced HER2-positive breast cancer, developed neurological symptoms that prompted CSF testing. After diagnosis, targeted T-DM1 HER2 receptor therapy produced complete response within 30 days and enabled survival for an additional 16 months.

LanguageEnglish

CategoryHealthcare

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Pages7

Reading Time18 min

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Abstract

Introduction

life Case Report Complete Cerebrospinal Fluid Response to T-DM1 in HER2 Positive Metastatic Breast Cancer: A Case Report Francesca Zacchi 1, Elena Giontella 1,*, Alessia Nottegar 2 and Elena Fiorio 1 Citation: Zacchi, F.; Giontella, E.; Nottegar, A.; Fiorio, E. Complete Cerebrospinal Fluid Response to T-DM1 in HER2 Positive Metastatic Breast Cancer: A Case Report. Life 2023, 13, 756. [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.3390/life13030756](10.3390/life13030756) Academic Editor: Yong Weon Yi Received: 7 February 2023 Revised: 8 March 2023 Accepted: 9 March 2023 Published: 10 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Section of Oncology, Department of Medicine, University and Hospital Trust of Verona, 37126 Verona, Italy; [francyzacchi@gmail.com](francyzacchi@gmail.com) (F.Z.); elena.ﬁ[orio@aovr.veneto.it](orio@aovr.veneto.it) (E.F.) 2 Department of Pathology and Diagnostics, University and Hospital Trust of Verona, 37126 Verona, Italy; [alessia.nottegar@aovr.veneto.it](alessia.nottegar@aovr.veneto.it) * Correspondence: [giontelena@gmail.com](giontelena@gmail.com); Tel.: +39-340-222-8264 Abstract: Leptomeningeal carcinomatosis is a rare but serious consequence of pre-existing tumors, such as breast, lung, and gastrointestinal carcinomas. Further, leptomeningeal carcinomatosis is more frequently diagnosed with breast cancers, if only because breast cancers are diagnosed far more often than any other carcinomas. In this paper, we present the case of a leptomeningeal carcinomatosis patient who experienced complete remission following therapy targeted at the Her-2 (human epidermal growth factor receptor 2-positive) receptor. This patient's diagnosis was complicated by the fact that brain and column MRI imaging were clear, but analysis of the cerebrospinal ﬂuid led to the conclusion of leptomeningeal carcinomatosis. The tests were requested because the patient, under chemotherapy for advanced breast cancer at the time, reported some neurological symptoms. Following the diagnosis of leptomeningeal carcinomatosis and subsequent T-DM1 Her-2 receptor therapy, the patient showed a complete response to leptomeningeal carcinomatosis within 30 days and survived for another 16 months. This case offers compelling evidence that the effect TDM1 Her-2 receptor therapy has on a patient's remission and long-term survivability is considerably better than other therapies for similar pre-existing conditions diagnosed with leptomeningeal carcinomatosis. Further prospective studies should conﬁrm these ﬁndings. Keywords: breast cancer; leptomeningeal carcinomatosis; leptomeningeal metastasis; anti-HER2 therapy; human epidermal growth factor receptor 2; cerebrospinal ﬂuid; T-DM1 therapy 1. Introduction Leptomeningeal carcinomatosis (LC) is a rare, but very serious, condition and is most often diagnosed in breast cancer (BC) patients, occurring in a total of 5% of BC patients. This correlation is related to the fact that BC is diagnosed far more frequently than anyother cancer. LC is characterized by a severe impact on morbidity and mortality incidence and retains a dismal prognosis, even in patients treated with multi-modal, aggressive treatments. In fact, after a diagnosis of LC, the prognosis remains poor, with a median survival of a few months for patients receiving state-of-the-art treatment. LC leads to a devastating prognosis; however, disease presentation and prognostic factors are uncertain [1] . Concerning clinical features, LC can present itself with a large variety of symptoms making the diagnosis complicated; symptoms of LC arise according to the area of th

FAQs

What clinical condition is the case report centered on?

The report focuses on leptomeningeal carcinomatosis as a rare but serious complication associated with pre-existing tumors, particularly breast cancer.

Why was cerebrospinal fluid analysis necessary in the case?

Although brain and spinal MRI imaging were clear, cerebrospinal fluid analysis identified leptomeningeal carcinomatosis after the patient developed neurological symptoms.

What treatment and outcome are highlighted for the patient?

After diagnosis, the patient received T-DM1 HER2 receptor-targeted therapy, achieving a complete response within 30 days and surviving for another 16 months.

Sep 24, 2026

Uploaded by Finn