Metastatic carcinomatous cirrhosis from diffuse breast cancer liver metastasis: a case report.
Takahiro Komori, Norihide Yoneda, Kanako Terada et al.
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Case in brief
A woman in her 50s with a history of breast cancer treated by mastectomy and adjuvant hormone therapy, followed by resection of a local recurrence, presented with fatigue and abdominal distension. CT showed massive ascites, and contrast-enhanced CT and MRI demonstrated cirrhosis-like liver morphology. With no prior documented liver metastases or chemotherapy, metastatic carcinomatous cirrhosis was suspected. Transjugular biopsy confirmed extensive tumor infiltration of portal areas with fibrosis and scar formation dissecting the hepatic parenchyma.
What made this case unusual
Imaging resembled pseudocirrhosis, but biopsy showed diffuse metastatic tumor infiltration with fibrosis and scar formation, supporting metastatic carcinomatous cirrhosis—a distinct pathophysiology despite similar morphology.
Diagnostic / clinical pearl
In a patient with malignancy and rapidly progressive liver dysfunction, cirrhosis-like imaging should prompt consideration of metastatic carcinomatous cirrhosis; biopsy can distinguish it from pseudocirrhosis.