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The successful introduction of trastuzumab and other novel tyrosine kinase inhibitors (TKI) for treatment of HER2-positive breast carcinoma has resulted in lengthened survival for affected patients. In the context of this increased survival time, it has since emerged that patients who would otherwise have succumbed to the systemic progression of their disease have an increased propensity to develop metastases within the central nervous system (CNS) when compared with their HER2-negative counterparts.1 Recent literature shows that these metastatic deposits respond poorly to TKI therapy, most likely due to their inability to penetrate the blood brain barrier.2
We write to inform you of the first known reported case documenting a HER2-positive breast carcinoma metastasising to an intracranial meningioma, without evidence of additional CNS involvement. This report serves to highlight our increasing understanding of the pathogenesis of brain metastasis, and how this growing knowledge should …
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