Autopsy and Case Reports
https://app.periodikos.com.br/journal/autopsy/article/doi/10.4322/acr.2021.256
Autopsy and Case Reports
Clinical Case Report

Acute liver failure due to radiographically occult infiltration of urothelial cancer

Valentina Tosatto; João Cabral Pimentel; Cristiano Cruz; André Almeida; Matteo Boattini

Downloads: 2
Views: 1125

Abstract

ABSTRACT: Introduction: Acute liver failure (ALF) due to diffuse infiltrating solid malignancy without any focal lesions on radiographic imaging is rare.

Case report: A 70-year-old man was admitted due to mental confusion, abdominal pain, and ALF. Three years before, he had undergone a left nephrectomy for urothelial carcinoma followed by adjuvant chemotherapy. The abdominal computed tomography (CT) showed hepatomegaly and ascites. Ascitic fluid had transudate characteristics, with no malignant cells. Percutaneous liver biopsy (LB) showed diffuse liver infiltration of metastatic urothelial carcinoma. The patient rapidly deteriorated and died in a week due to ALF.

Discussion: History of solid cancer and hepatomegaly and/or liver failure without other obvious explanation should encourage to perform LB.

Conclusion: LB is warranted to avoid misdiagnosis, prolonged hospital stays, and delay in palliative care.

Keywords

Neoplasms, Biopsy, Palliative Care

References

1 Bernal W, Wendon J. Acute liver failure. N Engl J Med. 2013;369(26):2525-34. http://dx.doi.org/10.1056/NEJMra1208937. PMid:24369077.

2 van Marcke C, Coulier B, Gielen I, Maldague P. Acute liver failure secondary to metastatic liver infiltration: case report and review of the literature. Acta Gastroenterol Belg. 2013;76(4):436-8. PMid:24592549.

3 Campos FPF, Felipe-Silva A, Zerbini MCN. Anaplastic large cell lymphoma ALK-negative clinically mimicking alcoholic hepatitis - A review. Autops Case Rep. 2013;3(3):11-9. http://dx.doi.org/10.4322/acr.2013.023. PMid:31528614.

4 Athanasakis E, Mouloudi E, Prinianakis G, Kostaki M, Tzardi M, Georgopoulos D. Metastatic liver disease and fulminant hepatic failure: presentation of a case and review of the literature. Eur J Gastroenterol Hepatol. 2003;15(11):1235-40. http://dx.doi.org/10.1097/00042737-200311000-00014. PMid:14560159.

5 Alcalde M, Garcia-Diaz M, Pecellin J, et al. Acute liver failure due to diffuse intrasinusoidal metastases of urothelial carcinoma. Acta Gastroenterol Belg. 1996;59(2):163-5. PMid:8903067.

6 Alexopoulou A, Koskinas J, Deutsch M, Delladetsima J, Kountouras D, Dourakis SP. Acute liver failure as the initial manifestation of hepatic infiltration by a solid tumor: report of 5 cases and review of the literature. Tumori. 2006;92(4):354-7. http://dx.doi.org/10.1177/030089160609200417. PMid:17036530.

7 Varghese J, Jayanthi V, Patra S, Rela M. Massive infiltration of liver by metastatic adenocarcinoma: a rare cause of acute hepatic failure. J Clin Exp Hepatol. 2012;2(3):286-8. http://dx.doi.org/10.1016/j.jceh.2012.06.002. PMid:25755446.

8 Simone C, Murphy M, Shifrin R, Zuluaga Toro T, Reisman D. Rapid liver enlargement and hepatic failure secondary to radiographic occult tumor invasion: two case reports and review of the literature. J Med Case Reports. 2012;6(1):402. http://dx.doi.org/10.1186/1752-1947-6-402. PMid:23181360.

9 Lanzas Prieto JM, Alonso de la Campa JM, Guate Ortiz JL, et al. Insuficiencia hepática fulminante por metástasis hepática intrasinusoidal difusa en un paciente con carcinoma transicional de vejiga. Arch Esp Urol. 2002;55(5):547-51. PMid:12174423.

10 Nascimento AB, Mitchell DG, Rubin R, Weaver E. Sinusoidal spread of liver metastases from renal cell carcinoma: simulation of diffuse liver disease on MR imaging. Abdom Imaging. 2002;27(2):196-8. http://dx.doi.org/10.1007/s00261-001-0065-0. PMid:11847581.
 


Submitted date:
12/15/2020

Accepted date:
01/31/2021

Publication date:
03/12/2021

604b6300a953952f866e2bc5 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections