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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1802637
Case Report with Review of Literature

Development of Focal Nodular Hyperplasia Post Dual Anti-HER2 Blockade with Pertuzumab and Trastuzumab in a Patient with Breast Cancer: A Case Report and Literature Review

Udip Maheshwari
1   Department of Medical Oncology, MOC Cancer Care & Research Centre, Mumbai, Maharashtra, India
,
Disha Morzaria 
3   Department of Clinical Research, MOC Cancer Care & Research Centre, Mumbai, Maharashtra, India
,
Vashishth Maniar
1   Department of Medical Oncology, MOC Cancer Care & Research Centre, Mumbai, Maharashtra, India
,
Ritu Dave 
2   Department of Medical Oncology, MOC Cancer Care & Research Centre, Pune, Maharashtra, India
,
Nikhat Shaikh
4   Department of Clinical Operations, MOC Cancer Care & Research Centre, Mumbai, Maharashtra, India
,
Bhavin Jankharia
5   Consultant and Partner, Picture This, Mumbai, Maharashtra, India
,
Karthik Ganesan
6   Consultant, Picture This, Mumbai, Maharashtra, India
› Author Affiliations Funding None.
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Abstract

Targeted therapies like trastuzumab and pertuzumab have substantially improved outcomes in HER2-positive breast cancer with rare reports of significant adverse events. One such rarely reported adverse event is focal nodular hyperplasia (FNH), an uncommon hepatic condition, typically benign and asymptomatic, but its development following dual anti-HER2 therapy is not commonly documented. We report the case of a 61-year-old woman with HER2-positive breast cancer highlighting the unusual development of FNH following dual anti-HER2 therapy. Routine follow-up imaging posttreatment revealed the development of hepatic nodules. Imaging confirmed a diagnosis of FNH, with no radiologic evidence of malignancy or metastatic disease. The patient remained asymptomatic, and following hepatology consultation, continuation of treatment was recommended with regular imaging follow-up to monitor hepatic lesions. Although it is benign and asymptomatic, FNH warrants careful monitoring in patients on prolonged targeted therapy. Further research is required to elucidate the mechanisms underlying the association between HER2-targeted therapies and hepatic alterations, which could inform evidence-based strategies for monitoring and management in clinical practice.

Keywords

breast cancer - dual anti-HER2 blockade - focal nodular hyperplasia - pertuzumab - trastuzumab

Patient Consent

Consent has been obtained from the patients.


Authors' Contributions

U.M., V.M. contributed to the intellectual content and manuscript review. R.D., N.S., B.J., K.G. contributed to the literature search and radiological intervention of the data. N.S. contributed to the data acquisition. R.D. contributed to the clinical studies. D.M. contributed to the manuscript preparation and medical writing.




Publication History

Article published online:
20 February 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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