A case of cryptogenic pseudocirrhosis causing acute liver failure: when clinic and radiology work together

  • Martina Finocchi | marfihorse@gmail.com Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Ombretta Para Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Giacomo Zaccagnini Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Lorenzo Corbo Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Lucia Maddaluni Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Margherita Giampieri Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Eleonora Blasi Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Mattia Ronchetti Internal Medicine Department, Careggi University Hospital, Firenze, Italy.
  • Carlo Nozzoli Internal Medicine Department, Careggi University Hospital, Firenze, Italy.

Abstract

It is known that a wild spectrum of hepatic manifestations can be common presentations of metastatic breast cancer. Pseudocirrhosis pattern has been often described as almost always secondary to systemic chemotherapy and it is defined by morphological liver changes that mimic cirrhosis including capsular retraction, nodularity, parenchyma atrophy and caudate lobe, radiologically identifiable. Acute liver injury is an occasional complication in oncologic patients, and it outlines an organ failure when there is evidence of encephalopathy and coagulopathy (international normalized ratio >1.5) in the absence of pre-existing liver disease, with an illness of <26 weeks duration. The two most common etiologies are leukemia/lymphoma followed by breast cancer but also in this case, liver is involved almost always after chemotherapy, hormonotherapy or radiotherapy. Here we present a case of rapid evolving acute liver failure presented as cryptogenic pseudocirrhosis without any evidence of primitive breast cancer but an incidental demonstration.

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Published
2019-06-18
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Section
Case Reports
Keywords:
Acute liver failure, breast cancer, pseudocirrhosis.
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How to Cite
Finocchi, M., Para, O., Zaccagnini, G., Corbo, L., Maddaluni, L., Giampieri, M., Blasi, E., Ronchetti, M., & Nozzoli, C. (2019). A case of cryptogenic pseudocirrhosis causing acute liver failure: when clinic and radiology work together. Italian Journal of Medicine, 13(2), 121-123. https://doi.org/10.4081/itjm.2019.1129

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