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Washington University Experience | NEOPLASMS (METASTASES) | Gross Pathology | 22A0 Case 22 History
Case 22 History ---- The patient was a 40-year-old woman with a history of metastatic HER2-positive, ER/PR-negative breast carcinoma status post neoadjuvant therapy and bilateral mastectomy in 2021, with widespread metastases involving the brain, liver, bone, chest wall, pleura, and pericardium. She presented to Barnes-Jewish Hospital in 1/2026 with progressive dysarthria and decreased oral intake. Brain MRI demonstrated marked progression of intracranial metastatic disease with more than 50 lesions, associated posterior fossa mass effect, tonsillar and ascending transtentorial herniation, and brainstem compression against the clivus. Following discussion with the patient and her family regarding progression of brain metastasis, she entered hospice care and died a month later. (Thanks Dr. Brenndan Crumley for excellent dissection and gross photography)
