Fulminant hepatic failure secondary to malignant melanoma: Case report andreview of the literature

Malignant melanoma has a propensity to metastasize widely to many organs, i nvolving the liver in up to one-third of cases. Fulminant hepatic failure i s an unusual presentation of hepatic neoplasms, whether primary or metastat ic. We describe a case of malignant melanoma with liver metastases that rap idly progressed to fulminant hepatic failure and death. Striking elevations of liver tests, particularly lactate dehydrogenase, were seen. Liver biops y showed diffuse intrasinusoidal infiltration with melanoma cells, in patie nts with malignant melanoma, raised serum lactate dehydrogenase levels may suggest hepatic involvement, with extreme elevations possibly predictive of liver failure. (C) 1999 by Am. Coll. of Gastroenterology.