Pseudocirrhosis: A Case Series and Literature Review

Abstract

Pseudocirrhosis describes morphological changes of the liver that closely mimic cirrhosis, without the typical histopathological changes seen in cirrhosis. It most commonly occurs in patients with metastatic breast cancer, although it has been reported in other malignancies as well. Like in cirrhosis, portal hypertension is often seen in patients with pseudocirrhosis. Pseudocirrhosis is a rare but important complication of metastatic cancer. In this case series and literature review, we describe 6 patients with hormone-receptor-positive metastatic breast cancer. We report the significant morbidity associated with pseudocirrhosis in the course of treatment in patients with metastatic breast cancer.

Recurrent metastatic breast cancer presenting with portal hypertension and pseudocirrhosis

“…The term itself can be misleading, as patients present with clinical symptoms of portal hypertension. In a reported case series (n=6) of patients with established breast carcinoma, abdominal distension with ascites was the most common presenting complaint 3. It has been reported in several different cancers, including oesophageal,4 pancreatic,5 colorectal6 and thyroid,7 though the majority of cases have been seen with breast cancer primary.…”

Pseudocirrhosis in a Patient with New-Onset Dysphagia and History of Ovarian Carcinoma

“… 1 It is a rare complication seen in patients with a history of advanced carcinoma, predominantly breast with hepatic metastases (micro or macro), and treatment with systemic chemotherapy, in particular capecitabine, gemcitabine, trastuzumab, and paclitaxel. 2 - 5 Although the pathogenesis of pseudocirrhosis is uncertain, it is believed to be related to scarring and hepatic capsular retraction from the response of hepatic lesions to chemotherapy, focal fibrosis surrounding infiltrating hepatic metastases, and nodular regenerative hyperplasia following chemotherapy-induced hepatic ischemia and injury. 2 - 6 …”

“… 2 - 5 Although the pathogenesis of pseudocirrhosis is uncertain, it is believed to be related to scarring and hepatic capsular retraction from the response of hepatic lesions to chemotherapy, focal fibrosis surrounding infiltrating hepatic metastases, and nodular regenerative hyperplasia following chemotherapy-induced hepatic ischemia and injury. 2 - 6 …”

“…Pseudocirrhosis is a rare but important complication of metastatic carcinoma that can closely mimic cirrhosis. 1 , 2 While it has previously been described primarily in patients with breast carcinoma metastatic to the liver, it is vital to consider as a clinical entity in patients with other types of metastatic malignancy to better guide diagnosis and treatment.…”

Pseudocirrhosis of the liver in setting of metastatic carcinoma breast: An ominous sign to be remembered

“…In their extensive research, Adike et al . [ 5 ] have enlisted only eighteen publications in addition to theirs that describe this phenomenon. The cases described in the literature show increased mortality and morbidity for this subset of the patients, as exemplified by our case, and demonstration of this phenomenon in imaging should alert the treating clinician.…”