Hepatic Coma Secondary to Metastatic Liver Disease

Eras, Philip; Sherlock, Paul

doi:10.7326/0003-4819-74-4-581

Cited by 32 publications

(7 citation statements)

References 5 publications

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“…Since then there have been several cases of fulminant hepatic failure complicating metastatic breast cancer, gastric cancer, lung cancer, malignant melanomas, leukemias, lymphomas and nasopharyngeal carcinoma [2][3][4][5] . In the previously reported cases the clinical features were non-specifi c and the laboratory fi ndings were compatible with hepatic involvement with elevation of total bilirubin, ALT, AST, LDH, and severe coagulopathy.…”

Section: Discussionmentioning

confidence: 99%

Fulminant Hepatic Failure Secondary to Metastatic Prostate Cancer

Boyiadzis

Nam²,

Dahut³

2005

Urol Int

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The most common sites of metastatic disease from prostate cancer include the bones, lymph nodes and less commonly the lungs, adrenal glands, brain and kidneys. Acute fulminant hepatic failure secondary to cancer metastasis is rare and has unique clinical presentation. We describe a case of fatal liver failure in a 71-year-old male due to metastases to the liver from a prostatic adenocarcinoma. Thus in patients with metastatic cancer and elevated liver function tests, the possibility of hepatic involvement by the cancer should be considered as a possible cause of hepatic failure.

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Section: Discussionmentioning

confidence: 99%

Fulminant Hepatic Failure Secondary to Metastatic Prostate Cancer

Boyiadzis

Nam²,

Dahut³

2005

Urol Int

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“…In general, acetaminophen toxicity results in hyper-acute failure while viral hepatitis leads to slower, acute or subacute onset [1]. Although acetaminophen or drug toxicity and viral hepatitis are the most common etiologies that result in hyper-acute and acute liver failure, there are reports secondary to hepatic infiltration by malignancies including Hodgkin's lymphoma [3-5], non-Hodgkin's lymphoma [6-8], adenocarcinomas [9-14], melanoma [9-12, 14], anaplastic tumors [9-12, 14] and small cell carcinoma of the prostate [15] or lung [10, 12, 16]. …”

Section: Introductionmentioning

confidence: 99%

Unique morphologic and clinical features of liver predominant/primary small cell carcinoma—autopsy and biopsy case series

et al. 2014

Annals of Diagnostic Pathology

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Liver predominant small cell carcinoma is rare, but often presents as hyper-acute liver failure with unknown primary and is a medical emergency. We present 2 autopsy and 7 biopsy cases of liver predominant small cell carcinoma and demonstrate that these patients present with liver failure and identifiable hepatomegaly, but lack discrete lesions on imaging, as well as no mass lesions identified in other organs including lung. Compared to the multiple nodules of metastatic small cell carcinoma in the liver, unique morphologic feature of liver predominant/primary small cell carcinoma in autopsy and biopsy specimens was a diffuse infiltration of small, blue, neoplastic cells predominantly in the sinusoidal space in the liver parenchyma. Prior to diagnosing liver predominant/primary small cell carcinoma, other infiltrating small blue cell neoplasms including lymphoma and peripheral neuroectodermal tumor need to be ruled out through immunohistochemistry (IHC). We therefore demonstrate that liver biopsy together with a rapid panel of immunostains is necessary to firmly establish a diagnosis of liver predominant small cell carcinoma and allow clinicians to immediately implement potentially lifesaving chemotherapy.

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“…Malignant infiltration is an uncommon cause of ALF (6) and carries a grave prognosis (7–9). The pathogenesis of the liver injury has not been clearly elucidated, although proposed mechanisms include extensive obstructive cholangitis (10); obstruction of hepatic venules (11) or sinusoids (12); and massive replacement of hepatocytes by malignant cells (11, 13, 14).…”

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confidence: 99%