Cirrhosis-like radiological pattern in patients with breast cancer.
BACKGROUND
Hepatic toxicity of breast cancer therapy is well known, usually consisting of elevation in the serum levels of hepatic enzymes or fatty infiltration of the liver. The chemotherapeutic agents most commonly linked to hepatotoxic effects are methotrexate, anthracyclines, taxanes and cyclophosphamide. There are few reports of patients with liver metastasis having radiological findings mimicking cirrhosis, both in the presence or the absence of prior systemic chemotherapy. Hepatotoxicity of antineoplastic drugs and cellular necrosis induced by response of liver metastases to chemotherapy may play a critical role in its physiopathology.


METHODS
This article reports a series of ten women with breast cancer (nine with liver metastasis) treated with chemotherapy or hormonotherapy.


RESULTS
They had low risk factors for hepatic disease, but developed a cirrhosis-like appearance in the computed tomography scan. The patient without liver metastasis is the second of this kind described in the literature. Relatively few reports have documented clinical sequelae of portal hypertension. In our series, three patients had oesophageal bleeding varices needing be hospitalised. To our knowledge, these are the first cases reported in the literature.


CONCLUSIONS
This suggests that some manifestations of portal hypertension may develop in association with the cirrhosis- like pattern induced by breast cancer therapy.
Gómez Raposo
César
C
Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain. c_gomezraposo@hotmail.com
Redondo Sánchez
Andrés
A
Guerra-Gutiérrez
Félix
F
Castelo Fernández
Beatriz
B
Gómez Senent
Silvia
S
Espinosa Arranz
Enrique
E
Martínez Martínez
Beatriz
B
Zamora Auñón
Pilar
P
González Barón
Manuel
M
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed