title: Complete response and long-term survival of leptomeningeal carcinomatosis from breast cancer with maintenance endocrine therapy.
abstract: Leptomeningeal carcinomatosis carries a poor prognosis in breast cancer. Treatment modalities are geared towards tumour molecular characteristics, as well as symptoms and patient performance status. It has previously been postulated that endocrine treatments used for the treatment of metastatic breast cancer do cross the blood-brain barrier and can achieve antineoplastic effects in the central nervous system. We report a case of metastatic breast cancer in a 65-year-old woman who developed leptomeningeal carcinomatosis. She was initially treated with intrathecal methotrexate, which was stopped due to toxicity, followed by maintenance endocrine therapy. She achieved a sustained complete radiological and cerebrospinal fluid cytological response for over 9 years. She eventually passed away of ischaemic bowel unrelated to her cancer.
authors.affiliation: Jewish General Hospital, McGill University, Montreal, Quebec, Canada Oncology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
authors.forename: Muneera Majed
authors.initials: MM
authors.lastname: Almajed
authors.affiliation: Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Khashayar
authors.initials: K
authors.lastname: Esfahani
authors.affiliation: Pathology Department, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Manuela
authors.initials: M
authors.lastname: Pelmus
authors.affiliation: Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Panasci
mesh_terms: D000368:Aged; D000730:Androstadienes / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D000077289:Letrozole; D055756:Meningeal Carcinomatosis / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000556:secondary; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D009570:Nitriles / Q000008:administration & dosage*; D013125:Spinal Neoplasms / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000556:secondary; D014230:Triazoles / Q000008:administration & dosage*
chemical_list: D000730:Androstadienes; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole; C056516:exemestane; D008727:Methotrexate