title: Acute hepatic failure secondary to extensive hepatic replacement by metastatic amelanotic melanoma: an autopsy case report.
abstract: Metastatic malignant melanoma (MM) of the liver evolving into acute hepatic failure is a rare occurrence. We describe the case of an 82-year-old man with a history of MM on the left thumb treated with amputation and chemotherapy 40 months previously. On admission, he had abdominal pain, weight loss, lethargy and jaundice. Radiologic investigations such as enhanced computed tomography and abdominal ultrasound failed to establish an etiologic diagnosis. A liver biopsy revealed amelanotic melanoma cells diffusely infiltrating the hepatic parenchyma. His liver injury progressed and the patient died of hepatic failure on the 13th hospital day. Autopsy revealed >70% infiltration by metastatic amelanotic melanoma in the liver.
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fusasaki
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. r-narita@med.uoeh-u.ac.jp.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Narita
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hiura
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Abe
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Akinari
authors.initials: A
authors.lastname: Tabaru
authors.affiliation: Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hino
authors.affiliation: First Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Atsuji
authors.initials: A
authors.lastname: Matsuyama
authors.affiliation: Second Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Shimajiri
authors.affiliation: Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Tokura
authors.affiliation: Second Department of Pathology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Sasaguri
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Harada
keywords: Acute hepatic failure; Amelanotic melanoma; Liver metastasis