case_images: PMC5836181_01
case_images: Magnetic resonance imaging of the brain after gadolinium injection. a FS axial view: enhancement over the midbrain surface and bilateral Sylvian fissure. b FS coronal view: nodular enhanced lesion at the left frontal base.
case_images: cro-0011-0068-g01.jpg
case_images: PMC5836181_01_cro-0011-0068-g01.jpg
case_images: F1
case_images: MRI demonstrated multiple enhanced lesions (Fig. 1), and CSF cytology examination confirmed the presence of malignant cells (Fig. 2).
case_images: ctDNA SMSEQ analysis of CSF. Blue box, expected ERBB2 (HER2) gene counts; black dot, ERBB2 gene counts (HER2 amplification) in the patient's CSF.
case_images: cro-0011-0068-g03.jpg
case_images: PMC5836181_01_cro-0011-0068-g03.jpg
case_images: F3
case_images: CDKN2A and TP53 genes (Fig. 3; Table 1). Considering the CSF-ctDNA NGS results and recommendations, ado-trastuzumab emtansine was added to the combination regimen of intrathecal trastuzumab and oral lapatinib.