To present a case of hepatic visceral crisis (HVC) in a patient with HER2-positive metastatic breast cancer and to discuss management strategies, highlighting the challenges and potential for recovery.
Key Findings:
The patient achieved complete biochemical recovery and sustained radiologic response following early dual HER2 blockade, demonstrating the effectiveness of this approach.
Treatment-related changes were observed in imaging, interpreted as pseudocirrhosis rather than disease progression, suggesting the need for careful interpretation of imaging results in similar cases.
Interpretation:
The case suggests that early and sustained HER2-targeted therapy can lead to meaningful clinical recovery in patients with HVC, emphasizing the potential for improved outcomes.
Limitations:
The management of HVC in HER2-positive metastatic breast cancer lacks robust prospective evidence due to exclusion of patients with severe hepatic dysfunction from clinical trials, complicating treatment decisions.
This case is a single instance and may not be generalizable to all patients with similar conditions, highlighting the need for more comprehensive studies.
Conclusion:
HVC in mBC-HER2+ is not uniformly irreversible; early HER2-directed therapy can restore organ function in selected patients, underscoring the importance of timely intervention.
by Joan Manuel Moreno Luján, Jorge Luis Soriano Lorenzo, Miguel Martínez Rubiño, Sònia Servitja Tormo, Tamara Martos Cárdenas, María Martínez García, Joan Albanell Mestres
