Metastatic prostatic carcinoma presenting as fulminant hepatic failure.
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.
Shakir
Faiz A
FA
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
Madhoun
Mohammed
M
Whorton
Joshua
J
Harty
Richard
R
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*
D017430:Prostate-Specific Antigen