Metastatic carcinomatosis of the liver mimicking cirrhosis: Case report and review of the literature

Borja, Egbert R.; Hori, Jose M.; Pugh, Reginald P.

doi:10.1002/1097-0142(197502)35:2<445::aid-cncr2820350222>3.0.co;2-g

Cited by 32 publications

(6 citation statements)

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“…The most frequently reported cause of pseudocirrhosis is metastatic breast cancer treated with chemotherapy [4][5][6][7][8][9][10][11][12][13][14] , which commonly presents with diffuse nodular changes of the liver surface on ct imaging 15 . However, the liver can also become nodular and resemble cirrhosis after hepatic metastasis in pancreatic, esophageal, and small-cell lung cancer [16][17][18] .…”

Section: Differential Diagnosismentioning

confidence: 99%

Medullary Thyroid Cancer and Pseudocirrhosis: Case Report and Literature Review

et al. 2012

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and spindle-cell morphologies, and a diagnosis of medullary thyroid carcinoma (mtc) was made.On baseline positron-emission tomography (pet)/ ct imaging, hypodensities corresponding to hypermetabolic foci in both hepatic lobes were observed [ Figure 1 , and cytokeratin 7, but negative for thyroglobulin, cytokeratin 20, and alpha-fetoprotein, which is consistent with mtc metastatic to the liver. At the time of diagnosis, the patient was not taking medications, and she had an unremarkable personal medical history and no family history of thyroid disease, endocrine disorders, or neoplasm.In March 2008, the patient enrolled in a phase i clinical trial (NCT00599924) of 5-fluorouracil (5fu), leucovorin, and oxaliplatin (folfox) in combination with sunitinib, a tyrosine kinase inhibitor with multiple targets, including the vascular endothelial growth factor receptor and the rearranged during transfection (RET) proto-oncogene, which is often upregulated in neuroendocrine tumors such as mtc 1 . The patient received folfox (leucovorin 400 mg/m 2 ; 5-fluorouracil 400 mg/m 2 intravenous bolus, followed by 2400 mg/m 2 infusion over 46 hours; oxaliplatin 85 mg/m 2 ) every 2 weeks and sunitinib 37.5 g daily for 4 weeks, followed by a 2-week rest period. In July 2008, after 4 months of folfox-sunitinib, the patient showed measureable tumor regression in the liver [Figure 1(D)] that qualified as a partial response according to the Response Evaluation Criteria in Solid Tumors. The folfox was discontinued, and the patient was maintained on single-agent sunitinib, which she tolerated well for 15 months with stable liver metastases. The patient underwent serial pet/ ct imaging without intravenous contrast to monitor her disease.In November 2009 (21 months after diagnosis), the patient developed abdominal bloating, early satiety, and right upper quadrant pain that increased with inspiration. Pulmonary exam demonstrated dullness ABSTRACT Pseudocirrhosis is a rare form of liver disease that can cause clinical symptoms and radiographic signs of cirrhosis; however, its histologic features suggest a distinct pathologic process. In the setting of cancer, hepatic metastases and systemic chemotherapy are suspected causes of pseudocirrhosis. Here, we present a patient with medullary thyroid carcinoma metastatic to the liver who developed pseudocirrhosis while on maintenance sunitinib after receiving 5-fluorouracil, leucovorin, and oxaliplatin (folfox) in combination with sunitinib. Cirrhotic change in liver morphology was accompanied by diffusely infiltrative carcinomatous disease resembling the primary tumor. We discuss the diagnosis of pseudocirrhosis in this case and review the literature regarding pseudocirrhosis in cancer. KEY WORDSMedullary thyroid cancer, pseudocirrhosis, carcinomatous cirrhosis CASE DESCRIPTIONA 49-year-old white woman presented in January 2008 with a left-sided cervical mass without associated complaints of neck pain, stridor, dysphonia, dysphagia, malaise, fever, or chills. Physical examination was remarkable for a f...

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Section: Differential Diagnosismentioning

confidence: 99%

Medullary Thyroid Cancer and Pseudocirrhosis: Case Report and Literature Review

et al. 2012

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“…Since that time, carcinomatosis or sinusoidal infiltration of the liver (also termed hepar lobatum carcinomatosum) has been reported due to primary tumors of the colon, pancreas, lung, stomach, kidney, adrenal, ovary, breast, and lymphomas [8]. Occult involvement of the liver due breast cancer has been described only in case reports and has been too rare to formally study [2, 3, 5, 6, 9–18]. Unfortunately, no authors have been able to elucidate common risk factors nor common shared biologic features (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Radiographically Occult Carcinomatous Spread of Breast Cancer to the Liver: A Challenging Case

Millard

Gupta

Brenin

et al. 2019

Case Reports in Oncological Medicine

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Metastatic carcinomatosis to the liver is a pattern of malignant infiltration that tends to provoke hepatic fibrosis. It is a rare complication of multiple solid tumor types and often seen in the absence of discrete tumor mass in the liver. We report a case of a 69-year-old woman with metastatic ductal carcinoma of the breast who presented with rising serum tumor markers and mildly cirrhotic contour of the liver on a CT scan. An early diagnosis of occult spread to the liver was made by means of a percutaneous liver biopsy showing desmoplastic response to invasive breast cancer cells found diffusely in the liver. This case highlights a rare pattern of metastatic spread of breast cancer as well as predisposing and prognostic features.

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“…Patients frequently experience a symptom-free interval after treatment of the primary malignancy before they develop nonspecific symptoms, including weight loss, nausea, and abdominal pain, consistent with our case. Patients ultimately develop hepatic dysfunction and evidence of liver failure such as bleeding varices, accumulation of ascites, jaundice, and hepatic encephalopathy [2-3,5].…”

Section: Discussionmentioning

confidence: 99%

Metastatic Carcinomatosis Cirrhosis: A Rare Pattern of Metastasis

Knouse

Hancock

Iwaz

et al. 2019

Cureus

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Metastatic carcinomatosis cirrhosis is a pattern of metastasis in which malignancy infiltrates the liver and provokes hepatic fibrosis. It is an especially rare complication of several malignancies, including breast cancer. We report a case of a 61-year-old woman with lobular carcinoma of the breast who presented with confusion and rising serum tumor markers without evidence of disease recurrence on imaging. She subsequently developed clinical evidence of hepatic dysfunction and a liver biopsy revealed diffuse infiltration of the liver by breast carcinoma with surrounding fibrous tissue deposition, consistent with metastatic carcinomatosis cirrhosis. This case highlights a rare and clinically significant pattern of metastasis and is the first to describe lobular carcinoma of the breast causing metastatic carcinomatosis cirrhosis.

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Metastatic carcinomatosis of the liver mimicking cirrhosis: Case report and review of the literature

Cited by 32 publications

References 1 publication

Medullary Thyroid Cancer and Pseudocirrhosis: Case Report and Literature Review

Medullary Thyroid Cancer and Pseudocirrhosis: Case Report and Literature Review

Radiographically Occult Carcinomatous Spread of Breast Cancer to the Liver: A Challenging Case

Metastatic Carcinomatosis Cirrhosis: A Rare Pattern of Metastasis

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