CASE REPORT article
Front. Oncol.
Sec. Breast Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1599148
This article is part of the Research TopicExploring the Breast Tumor Microenvironment: Association to Metastasis, Novel Risk Factors and Novel Treatments and Immunotherapies: Volume II.View all 4 articles
Case Report: Triple-negative breast cancer with brain and meningeal metastases exhibits spatiotemporal heterogeneity in terms of HER2 expression
Provisionally accepted
Xubin Wang
Zhiyun Weng*- Yueqing People's Hospital, Yueqing, China
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Meningeal carcinomatosis (MC) is a distinct form of brain metastasis (BM) that occurs in patients with advanced triple-negative breast cancer (TNBC). The occurrence of BM typically indicates poor prognosis. Spatial heterogeneity in HER2 expression is relatively common in breast cancer cases; however, the emergence of both temporal and spatial heterogeneity within the brain parenchyma and cerebrospinal fluid (CSF) is exceedingly rare. Thus, the phenomenon warrants further investigation.Herein, we report a case of advanced TNBC with BM and MC. HER-2 was expressed in the CSF and exhibited spatial and temporal heterogeneity. The CSF was analysed using immunohistochemistry and flow cytometry, confirming the presence of HER-2-positive tumour cells in the patient's CSF.MC was effectively controlled after treatment with trastuzumab deruxtecan (T-DXd). Relevant literature was reviewed to analyse the reasons for this phenomenon.In this case, the spatial and temporal heterogeneity of the HER-2 receptors observed in the CSF suggests that BM may be driven by the synergistic interaction of multiple sub-clonal tumour cells.
Keywords: Human epidermal growth factor receptor 2, trastuzumab deruxtecan, case report, Meningeal Carcinomatosis, triple-negative breast cancers
Received: 24 Mar 2025; Accepted: 30 May 2025.
Copyright: © 2025 Wang and Weng. 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) or licensor 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: Zhiyun Weng, Yueqing People's Hospital, Yueqing, China
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