title: Metastatic carcinoma presenting as fulminant hepatic failure.
abstract: An unusual cause of fulminant hepatic failure is described. The patient, who presented with symptoms of liver disease, proved to have a small primary oat cell carcinoma of the lung with massive hepatic metastases. The clinical evolution was rapid, with marked elevations of SGOT (this without a prior hypotensive episode) and hepatic coma. Examination of the liver showed two types of necrosis: 1. infarction secondary to multiple tumor emboli in portal vessels and 2. overrunning of hepatic cell plates by expanding masses of tumor cells (somewhat analogous to piecemeal necrosis).
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D018288:Carcinoma, Small Cell / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary*; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D009336:Necrosis