采用抗HER2治疗及放化疗的成熟畸胎瘤中的原发性纵隔HER2阳性大汗腺癌
Primary Mediastinal HER2-positive Apocrine Carcinoma in Mature Teratoma Treated With Anti-HER2 Therapy and Chemoradiation.
作者信息
Sugiyama Keiji, Iwakoshi Akari, Satoh Mariko, Shiraishi Kazuhiro, Nozawa Kazuki, Kogure Yoshihito, Kitagawa Chiyoe, Moritani Suzuko, Katoh Eriko, Saka Hideo
机构信息
Department of Medical Oncology, Nagoya Medical Center, Nagoya, Japan
Department of Pathology, Nagoya Medical Center, Nagoya, Japan.
出版信息
In Vivo. 2019 Mar-Apr;33(2):551-557. doi: 10.21873/invivo.11509.
BACKGROUND
There are no established guidelines for the management of apocrine carcinomas of the breast; they are treated as a non-specific type of breast cancer.
CASE REPORT
We report on the case of a 40-year-old man who developed primary mediastinal apocrine carcinoma overexpressing human epidermal growth factor-2 (HER2). The patient initially underwent complete resection of a mediastinal mature teratoma with a focal apocrine carcinoma component. Two years after surgery, relapse was detected in multiple mediastinal lymph nodes. He received induction chemotherapy including docetaxel, trastuzumab, and pertuzumab; consolidative concurrent chemoradiation was added after six cycles. A complete response was confirmed using computed tomography following this multimodal therapy. After chemoradiation, adjuvant trastuzumab and pertuzumab were administered for 1 year and the patient has since had no evidence of progressive disease.
CONCLUSION
A multi-modal regimen that includes an anti-HER2 agent appears to be a promising treatment for patients with HER2-positive extramammary apocrine carcinoma.
背景
目前尚无关于乳腺大汗腺癌管理的既定指南；它们被当作一种非特异性乳腺癌类型进行治疗。
病例报告
我们报告了一例40岁男性原发性纵隔大汗腺癌患者，该肿瘤过度表达人表皮生长因子-2（HER2）。患者最初接受了纵隔成熟畸胎瘤伴局灶性大汗腺癌成分的完整切除。术后两年，在多个纵隔淋巴结检测到复发。他接受了包括多西他赛、曲妥珠单抗和帕妥珠单抗在内的诱导化疗；六个周期后增加了巩固性同步放化疗。采用多模态治疗后通过计算机断层扫描确认了完全缓解。放化疗后，给予曲妥珠单抗和帕妥珠单抗辅助治疗1年，此后患者无疾病进展迹象。
结论
包括抗HER2药物的多模态治疗方案似乎是HER2阳性乳腺外大汗腺癌患者的一种有前景的治疗方法。
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