title: Subacute liver failure by pseudocirrhotic metastatic breast cancer infiltration.
abstract: Hepatic metastases are common in the clinical course of breast cancer and typically appear as mass lesions. This report describes the case of a 70-year-old woman with a history of breast cancer and no previously known liver disease presenting with the first episode of variceal bleeding and subacute hepatic failure. Imaging studies indicated liver cirrhosis without signs of malignant focal lesions. Comprehensive diagnostic work-up was negative for specific causes of liver disease and provided no evidence for tumor recurrence. Finally transjugular liver biopsy revealed a marked diffuse desmoplastic infiltration by breast cancer cells. Malignant pseudocirrhosis is an unusual pattern of metastatic, tumor spread representing a rare but important differential diagnosis of progressive liver failure. Liver biopsy is the key procedure to establish the diagnosis as imaging studies may mimic cirrhosis.
authors.affiliation: Department of Medicine II,Saarland University Medical Center, Homburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Jüngst
authors.forename: Jens
authors.initials: J
authors.lastname: Krämer
authors.forename: Günther
authors.initials: G
authors.lastname: Schneider
authors.forename: Frank
authors.initials: F
authors.lastname: Lammert
authors.forename: Vincent
authors.initials: V
authors.lastname: Zimmer
mesh_terms: D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000556:secondary* / Q000628:therapy; D003937:Diagnosis, Differential; D018450:Disease Progression; D004932:Esophageal and Gastric Varices / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis; D017093:Liver Failure / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests