Pseudocirrhosis caused by regorafenib in an advanced rectal cancer patient with multiple liver metastases

Kumamoto, Kensuke; Endo, Shunsuke; Isohata, Noriyuki; Nirei, Azuma; Nemoto, Daiki; Utano, Kenichi; Saito, Takuro; Togashi, Kazutomo

doi:10.3892/mco.2016.1096

Cited by 7 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of other reports on pseudocirrhosis are associated with hepatic metastasis of breast cancer (2,(4)(5)(6)(7)(8)(9)(10)(11)18). Furthermore, although there have been some case reports of pseudocirrhosis in various primary cancers with liver metastases (3,(12)(13)(14)(15)(16)(17)19), these reports suggested no correlation with the specific type of cancer.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pseudocirrhosis after chemotherapy for gastric cancer with diffuse liver metastases: A case report

et al. 2021

View full text Add to dashboard Cite

Pseudocirrhosis is a rare but important complication of metastatic cancer. We herein present the case of a patient with pseudocirrhosis occurring after a complete response to chemotherapy for metastatic gastric cancer was achieved. A 72-year-old man was diagnosed with gastric adenocarcinoma with multiple liver metastases. The patient's general condition was good, with an Eastern Cooperative Oncology Group performance status of 1. Chemotherapy with oxaliplatin and S-1 was initiated and, after four cycles, the patient noticed sudden abdominal distension. Despite the marked regression of the liver metastases, massive ascites, segmental atrophy and esophageal varices developed, findings consistent with pseudocirrhosis. The patient achieved complete response for the primary and metastatic lesions. Following endoscopic ligation of the varices, he underwent subsequent chemotherapy with S-1 only and management of his ascites for 6 months. At 12 months after initial chemotherapy, the patient appeared to be disease-free. In conclusion, clinicians should be aware of the possibility of pseudocirrhosis in cases of cancer metastasis to the liver, including metastatic gastric cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Pseudocirrhosis is a term used to describe a complication of cancer with multiple liver metastases, and its radiological appearance is similar to that of cirrhosis ( 17 ). However, there is no examination that can definitively distinguish pseudocirrhosis from cirrhosis, and the typical histopathological findings of cirrhosis are lacking.…”

Section: Discussionmentioning

confidence: 99%

Pseudocirrhosis after chemotherapy for gastric cancer with diffuse liver metastases: A case report

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Pseudocirrhosis is a radiologic diagnosis that describes morphologic changes of the liver mimicking cirrhosis that arise in the setting of metastatic malignancy. Most cases in the published literature are found in metastatic breast cancer [ 1 , 4 , 6 , 26 , 54 ], but cases have been reported in other primary malignancies, including pancreatic [ 43 ], colorectal [ 44 , 45 ], gastric [ 46 – 48 ], esophageal [ 49 ], lung [ 50 , 51 ], ovarian [ 52 ], and medullary thyroid cancers [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pseudocirrhosis has been most frequently described in the setting of metastatic breast cancer [ 38 – 42 ]. Apart from breast cancer, cases have been reported in primary malignancies, such as pancreatic [ 43 ], colorectal [ 44 , 45 ], gastric [ 46 – 48 ], esophageal [ 49 ], lung [ 50 , 51 ], ovarian [ 52 ], and medullary thyroid cancers [ 53 ].…”

Section: Introductionmentioning

confidence: 99%

Pseudocirrhosis: A Case Series with Clinical and Radiographic Correlation and Review of the Literature

Sadlik,

Anderson,

Lei

et al. 2024

Dig Dis Sci

View full text Add to dashboard Cite

Background and aims Pseudocirrhosis is a poorly understood acquired morphologic change of the liver that occurs in the setting of metastatic malignancy and radiographically resembles cirrhosis. Pseudocirrhosis has been primarily described in metastatic breast carcinoma, with few case reports arising from other primary malignancies. We present 29 cases of pseudocirrhosis, including several cases from primary malignancies not previously described. Methods Radiologic, clinical, demographic, and biomedical data were collected retrospectively and analyzed. We compared clinical and radiologic characteristics and outcomes between patients with pseudocirrhosis arising in metastatic breast cancer and non-breast primary malignancies. Results Among the 29 patients, 14 had breast cancer and 15 had non-breast primaries including previously never reported primaries associated with pseudocirrhosis, melanoma, renal cell carcinoma, appendiceal carcinoid, and cholangiocarcinoma. Median time from cancer diagnosis to development of pseudocirrhosis was 80.8 months for patients with primary breast cancer and 29.8 months for non-breast primary ( p = 0.02). Among all patients, 15 (52%) had radiographic features of portal hypertension. Radiographic evidence of portal hypertension was identified in 28.6% of breast cancer patients, compared to 73.3% of those with non-breast malignancies ( p = 0.03). Conclusion Pseudocirrhosis has most commonly been described in the setting of metastatic breast cancer but occurs in any metastatic disease to the liver. Our study suggests that portal hypertensive complications are more common in the setting of non-breast primary cancers than in metastatic breast cancer. Prior exposure to multiple chemotherapeutic agents, and agents known to cause sinusoidal injury, is a common feature but not essential for the development of pseudocirrhosis.

show abstract

“…However, this under-recognized and under-reported entity is typified by a distinctly more rapid clinical course as well as the absence of bridging fibrosis between regenerating nodules on histological examination (1,5). Though pseudocirrhosis was initially described almost exclusively in patients with breast cancer and liver metastases in the setting of systemic therapies, isolated cases have subsequently been reported in non-metastatic breast as well as colorectal, esophageal, pancreatic, ovarian, and thyroid cancers (6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Pseudocirrhosis in Breast Cancer – Experience From an Academic Cancer Center

et al. 2021

View full text Add to dashboard Cite

BackgroundPseudocirrhosis is characterized by radiological changes in the liver that resemble cirrhosis, but with more rapid onset and progression. Though reported most frequently in patients with metastatic breast cancer, little is known about its prognostic factors and impact on breast cancer outcomes.MethodsIn this observational study, we reviewed abdominal CT and/or MRI scan reports of all patients with invasive breast cancer diagnosed at our center, during a ten-year period, to identify patients with pseudocirrhosis. Exclusion criteria included lack of baseline imaging, pre-existing cirrhosis, hepatitis B or C, other chronic liver diseases, or heavy alcohol use. Routine descriptive statistical measures were used. Survival distributions were estimated using Kaplan-Meier method, and Cox regression was used for multivariate analysis. Two-tailed p < 0.05 was considered significant.ResultsEighty-six patients were included – all were females, median age was 57.5 years, and 90% were Caucasian; 86% of primary tumors were hormone-receptor positive and 17% were HER2 positive. Most patients (98%) had metastatic disease with liver involvement (94%), and were heavily pre-treated – 97% with chemotherapy, 85% with hormonal therapy, and 19% with anti-HER2 agents. Median interval from breast cancer diagnosis to pseudocirrhosis was 75.4 months (IQR 35.2-115.3 months). Thirty-six percentage of patients had ≥1 signs of portal hypertension and 49% had ≥1 signs of hepatocellular failure. Pseudocirrhosis led to permanent discontinuation of chemotherapy, endocrine therapy, and all systemic therapies in 29%, 31%, and 20% patients, respectively. Median overall survival from diagnosis of pseudocirrhosis was 10.0 months (95%CI 5.2-14.8 months). On multivariate analysis, coagulopathy, hyperbilirubinemia, hypoalbuminemia, and cancer progression were independently predictive of mortality.ConclusionsIn this largest series, to date, of breast cancer with pseudocirrhosis, the latter was often complicated by portal hypertension and hepatocellular failure, and markedly impacted breast cancer management. Survival was shorter for patients who developed hepatocellular failure.

show abstract

Pseudocirrhosis caused by regorafenib in an advanced rectal cancer patient with multiple liver metastases

Cited by 7 publications

References 17 publications

Pseudocirrhosis after chemotherapy for gastric cancer with diffuse liver metastases: A case report

Pseudocirrhosis after chemotherapy for gastric cancer with diffuse liver metastases: A case report

Pseudocirrhosis: A Case Series with Clinical and Radiographic Correlation and Review of the Literature

Pseudocirrhosis in Breast Cancer – Experience From an Academic Cancer Center

Contact Info

Product

Resources

About