A Case of Solitary Brain Metastasis Two Years after Resection of HER2-Positive Advanced Gastric Cancer

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  • Shingaki Kodai
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Ohuchida Kenoki
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Tsutsumi Chikanori
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Shindo Koji
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Moriyama Taiki
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Fujioka Yutaka
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • Shimogawa Takafumi
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • Matsumoto Takamasa
    Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University
  • Mori Taro
    Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University
  • Tamura Koji
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Nagayoshi Kinuko
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Ikenaga Naoki
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Nakata Kohei
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University
  • Yoshimoto Koji
    Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
  • Oda Yoshinao
    Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University
  • Nakamura Masafumi
    Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University

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Other Title
  • HER2陽性進行胃癌切除後2年で単独脳転移を呈した1例

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<p>A 75-year-old man underwent laparoscopic total gastrectomy for advanced gastric cancer in 2020. Pathological diagnosis showed lymphatic invasion at the oral margin and the gastrectomy was considered a non-curative resection. Immunostaining showed HER2[3+] and the patient received 8 courses of trastuzumab+capecitabine+cisplatin and 16 courses of capecitabine monotherapy as adjuvant chemotherapy. About 2 years after surgery, the patient was referred to a local hospital due to weakness in the left lower limb and a fall. A CT scan revealed a metastatic brain tumor. When he was transferred to our hospital, there was no other metastasis. The patient then underwent craniotomy at the Department of Neurosurgery. Postoperative pathology determined that the tumor was a metastatic tumor of gastric cancer. The patient had a single intracranial recurrence after trastuzumab administration. Therefore, we administered nivolumab to prevent systemic recurrence including additional intracranial metastasis. The patient has been recurrence-free for 6 months after craniotomy. In this report, we describe a case of a patient with a solitary brain metastasis after anti-HER2 therapy following resection of HER2-positive advanced gastric cancer.</p>

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