case_images: PMC6319676_01
case_images: (A) Hematoxylin and eosin stain of ampullary carcinoma in liver biopsy. (B) HER-2 staining of ampullary carcinoma in liver biopsy.
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case_images: PMC6319676_01_fig-1.jpg
case_images: f1
case_images: He subsequently underwent biopsy of an enlarging liver lesion, which was positive for adenocarcinoma consistent with metastatic ampullary carcinoma. HER-2 immunohistochemistry (IHC) demonstrated 80% strong positive staining in this liver biopsy sample (Fig. 1).
case_images: Chest computed tomography scans from January 2005 (A) and April 2015 (B) demonstrating interval improvement in lesions following initiation of trastuzumab and pertuzumab.
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case_images: PMC6319676_01_fig-2.jpg
case_images: f2
case_images: April 2015 demonstrated radiological improvement in disease, which did not meet the RECIST criteria for a partial response to therapy and, as such, was termed stable disease (Fig. 2). A 1.3 cm lung lesion decreased to 1.1 cm, a second 1.3 cm lung lesion measured 0.8 cm, and a 2.4 x 2.5 cm liver lesion decreased to 2.2 x 2.2 cm.