9/9
The takeaway:
๐ต HER2 3+ rules out anti-EGFR therapy
๐ต Opens access to two approved targeted regimens
๐ต Age is not a reason to treat blind
Test it, it really matters.
#gipath#pathtwitter#pathology
๐งต 1/9
Elderly male. Metastatic colorectal cancer with liver mets. RAS wild-type โ looks straightforward.
Then the molecular profile comes back: HER2 IHC 3+.
This changes the entire treatment plan. Here's why ๐
8/9
Key detail on testing ๐ฌ
IHC 3+ responds well. IHC 2+ without amplification โ almost no benefit.
Use HERACLES criteria, not breast cancer scoring. And when possible, test the metastatic tissue โ not just the primary.
๐งต 1/6
A nodule on the face. Sent as a skin biopsy. No clinical history provided. Spoiler: this is NOT a primary skin tumor. ๐
#pathtwitter#dermpath#uropath#pathology
6/6
Bottom line: clinical history is not just background noise โ it is part of the diagnosis. Never forget that ๐
Have you ever seen a case like this? ๐
5/6
๐ Take-home points:
โ Clear cells in skin = always rule out metastasis
โ RCC loves to metastasize late and to unusual sites
โ PAX8 + CD10 + CAIX = your best IHC friends here