PMC6319676_01
(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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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).
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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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.