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Case Report ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2018.00274

Trastuzumab Emtansine for the Treatment of HER-2 Positive Carcinoma Ex-Pleomorphic Adenoma Metastatic to the Brain: A Case Report.

  • 1Radiation oncology, American University of Beirut, Lebanon
  • 2Pathology, American University of Beirut, Lebanon

Background:
Carcinoma Ex-pleomorphic adenoma is a malignant transformation of the common benign
neoplasm of the salivary glands, “pleomorphic adenoma”. Only two cases were ever reported with brain metastases, with absence of good evidence guiding management of such cases.
Case presentation:
A 61-year-old woman presenting with facial paralysis was found to have carcinoma ex-pleomorphic adenoma of the parotid gland. Twenty months after local treatment, she developed brain metastases, treated with whole brain radiation therapy. The patient then had progressive intracranial disease after the end of radiation therapy in addition to the appearance of liver metastases. Pathology showed overexpression of HER2, so she was treated with Trastuzumab Emtansine (TDM1). Follow-up imaging revealed significant decrease in the number and size of the metastatic brain lesions in keeping with a good response to TDM1 treatment.
Conclusion:
Prognosis of metastatic carcinoma ex-pleomorphic adenoma is very poor, and there is no clear
management for such cases. We present a case of carcinoma ex-pleomorphic adenoma with
brain and liver metastases with a very good response to TDM1 treatment.

Keywords: Carcinoma ex-pleomorphic adenoma, Trastuzumab emtansin, brain metastasis, radiotherapy., her2/neu

Received: 14 May 2018; Accepted: 02 Jul 2018.

Edited by:

ANTOINE ITALIANO, Université de Bordeaux, France

Reviewed by:

Vijay Pandey, Cancer Science Institute of Singapore, National University of Singapore, Singapore
Fabrizio Martelli, Istituto Superiore di Sanità, Italy  

Copyright: © 2018 Hassanieh, Hilal, Al Feghali, Khalifeh and Youssef. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Bassem Youssef, American University of Beirut, Radiation oncology, Beirut, Lebanon, bassdok@hotmail.com