Primary Mediastinal HER2-positive Apocrine Carcinoma in Mature Teratoma Treated With Anti-HER2 Therapy and Chemoradiation

Abstract

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 HER2positive extramammary apocrine carcinoma.Primary mediastinal tumours encompass a variety of histological types including thymoma/thymic cancer, germ cell tumours, cystic disease, neurogenic tumours, lymphoma, 551 This article is freely accessible online.

Immune-related mechanisms and immunotherapy in extragonadal germ cell tumors

“…Chovanec et al (82) analyzed the immunoinflammatory index according to platelet count, neutrophil count, and number of tumor-infiltrating lymphocytes. At the same time, many clinical studies in patients with a variety of GCTs have tested various antibody treatments such as tislelizumab and pembrolizumab, with some patients achieving remission and showing favorable clinical outcomes, while others had to stop treatment due to poor efficacy or clinically insignificant benefit (83)(84)(85)(86)(87)(88). A Phase II study of pembrolizumab, an anti-PD-L1 monoclonal antibody, did not show any clinical response among the first 12 patients enrolled (NCT02499952) (89).…”