title: Metastatic prostatic carcinoma presenting as fulminant hepatic failure.
abstract: A 68-year-old male presented with progressive abdominal pain, dyspnea, weight loss, and dysuria. Lab work revealed elevated creatine phosphokinase levels, prostate-specific antigen level (approximately 60 ng/mL), and elevated liver enzymes. He was admitted to the intensive care unit for worsening respiratory distress and confusion. He continued to deteriorate, and his bilirubin peaked at 8.5 mg/dL. The patient subsequently died, and an autopsy revealed extensive hepatic necrosis with diffuse intravascular and intraparenchymal permeation of metastatic prostatic carcinoma. Fulminant hepatic failure remains a rare presentation of metastatic prostatic carcinoma, with a rapidly progressive course toward hepatic coma and death. A high index of suspicion is needed to investigate the possibility of palliative chemotherapy.
authors.affiliation: Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. faiz-shakir@ouhsc.edu
authors.forename: Faiz A
authors.initials: FA
authors.lastname: Shakir
authors.forename: Mohammed
authors.initials: M
authors.lastname: Madhoun
authors.forename: Joshua
authors.initials: J
authors.lastname: Whorton
authors.forename: Richard
authors.initials: R
authors.lastname: Harty
mesh_terms: D000368:Aged; D017809:Fatal Outcome; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary*; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology*
chemical_list: D017430:Prostate-Specific Antigen