Fulminant hepatic failure caused by diffuse intrasinusoidal metastatic liver disease: A case report

A 53-year-old woman experienced rapidly progressing liver failure four year s after a quadrantectomy for a breast carcinoma. She had received adjuvant chemotherapy and radiotherapy, and second-fine chemotherapy for bone metast asis one year earlier. The hepatic failure manifested with ascites, jaundic e, elevation of serum bilirubin and hepatic enzyme levels and hypoalbuminem ia. Imaging studies showed an enlarged liver without metastatic lesions. Th e patient died of hepatic decompensation within two weeks. liver examinatio n at autopsy revealed massive neoplastic Infiltration consistent with a pri mary breast carcinoma. It is Important to realize that this unusual pattern of liver metastasis cannot be demonstrated even with the most advanced tec hniques of Instrumental diagnosis (CT scan, ultrasonography and magnetic re sonance imaging), and should be taken Into account In the differential diag nosis of rapidly progressing liver failure.