Chemotherapy-induced complete regression of choroidal metastases and subsequent isolated leptomeningeal carcinomatosis in advanced breast cancer: a case report and literature review

J Neurooncol. 2000 Apr;47(2):161-5. doi: 10.1023/a:1006449215047.

Abstract

Choroidal metastases from breast cancer represent an unusual metastatic presentation that has been traditionally treated with radiation therapy. Herein, we report a case of metastatic breast cancer presenting with pulmonary, cutaneous, lymph node and symptomatic choroidal metastases treated with systemic combination chemotherapy incorporating docetaxel and mitoxantrone without induction or consolidation radiation therapy to control visual symptoms from choroidal metastases. The patient experienced a durable complete remission in all metastatic sites that was maintained for 21 months since the initiation of chemotherapy, afterwhich she developed isolated leptomeningeal carcinomatosis managed successfully with intensive intrathecal methotrexate and whole brain irradiation leading to a new complete remission maintained until this report; 11 months after its presentation. This is the first case to our knowledge reporting complete regression of choroidal metastases with docetaxel-based chemotherapy as the only treatment modality and subsequent isolated leptomeningeal carcinomatosis recurrence.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology*
  • Carcinoma, Ductal, Breast / drug therapy
  • Carcinoma, Ductal, Breast / radiotherapy
  • Carcinoma, Ductal, Breast / secondary*
  • Choroid Neoplasms / drug therapy*
  • Choroid Neoplasms / secondary*
  • Combined Modality Therapy
  • Docetaxel
  • Female
  • Humans
  • Meningeal Neoplasms / secondary*
  • Meningeal Neoplasms / therapy
  • Methotrexate / administration & dosage
  • Mitoxantrone / administration & dosage
  • Paclitaxel / administration & dosage
  • Paclitaxel / analogs & derivatives
  • Survival Analysis
  • Taxoids*

Substances

  • Taxoids
  • Docetaxel
  • Mitoxantrone
  • Paclitaxel
  • Methotrexate