Diffuse Desmoplastic Breast Carcinoma Metastases to the Liver Simulating Cirrhosis at MR Imaging: Report of Two Cases

Nascimento, Alessandra B.; Mitchell, Donald G.; Rubin, Raphael; Weaver, Eric J.

doi:10.1148/radiol.2211001754

Cited by 52 publications

(43 citation statements)

References 11 publications

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“…In contrast, the second form of "pseudocirrhosis" occurs in the absence of treated metastatic Ca where hepatic histology shows evidence of extensive fibrosis representing a profound desmoplastic response to the infiltrating tumor [2]. Interestingly, although our patient had received chemotherapy, this was administered prior to the development of metastatic disease and her autopsy findings were consistent with a desmoplastic reaction.…”

Section: Discussionmentioning

confidence: 72%

“…A cirrhotic-appearing liver has been described previously in the setting of metastatic breast Ca in both the presence and the absence of prior systemic chemotherapy [1][2][3]. In the former, the "pseudocirrhosis" is thought to result from hepatic capsular retraction in response to chemotherapeutic agents.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatic metastases from breast cancer can occasionally mimic cirrhosis anatomically, in both the presence and the absence of prior systemic chemotherapy [1][2][3]. We present a case of diffuse desmoplastic metastatic breast carcinoma (Ca) masquerading as cirrhosis that presented with newonset jaundice associated with severe portal hypertension and its sequelae.…”

Section: Introductionmentioning

confidence: 99%

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Diffuse Desmoplastic Metastatic Breast Cancer Simulating Cirrhosis with Severe Portal Hypertension: A Case of “Pseudocirrhosis”

et al. 2007

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diffuse Desmoplastic Metastatic Breast Cancer Simulating Cirrhosis with Severe Portal Hypertension: A Case of “Pseudocirrhosis”

et al. 2007

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“…The most frequently reported cause of pseudocirrhosis is metastatic breast cancer treated with chemotherapy [4][5][6][7][8][9][10][11][12][13][14] , which commonly presents with diffuse nodular changes of the liver surface on ct imaging 15 . However, the liver can also become nodular and resemble cirrhosis after hepatic metastasis in pancreatic, esophageal, and small-cell lung cancer [16][17][18] .…”

Section: Differential Diagnosismentioning

confidence: 99%

Medullary Thyroid Cancer and Pseudocirrhosis: Case Report and Literature Review

et al. 2012

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and spindle-cell morphologies, and a diagnosis of medullary thyroid carcinoma (mtc) was made.On baseline positron-emission tomography (pet)/ ct imaging, hypodensities corresponding to hypermetabolic foci in both hepatic lobes were observed [ Figure 1 , and cytokeratin 7, but negative for thyroglobulin, cytokeratin 20, and alpha-fetoprotein, which is consistent with mtc metastatic to the liver. At the time of diagnosis, the patient was not taking medications, and she had an unremarkable personal medical history and no family history of thyroid disease, endocrine disorders, or neoplasm.In March 2008, the patient enrolled in a phase i clinical trial (NCT00599924) of 5-fluorouracil (5fu), leucovorin, and oxaliplatin (folfox) in combination with sunitinib, a tyrosine kinase inhibitor with multiple targets, including the vascular endothelial growth factor receptor and the rearranged during transfection (RET) proto-oncogene, which is often upregulated in neuroendocrine tumors such as mtc 1 . The patient received folfox (leucovorin 400 mg/m 2 ; 5-fluorouracil 400 mg/m 2 intravenous bolus, followed by 2400 mg/m 2 infusion over 46 hours; oxaliplatin 85 mg/m 2 ) every 2 weeks and sunitinib 37.5 g daily for 4 weeks, followed by a 2-week rest period. In July 2008, after 4 months of folfox-sunitinib, the patient showed measureable tumor regression in the liver [Figure 1(D)] that qualified as a partial response according to the Response Evaluation Criteria in Solid Tumors. The folfox was discontinued, and the patient was maintained on single-agent sunitinib, which she tolerated well for 15 months with stable liver metastases. The patient underwent serial pet/ ct imaging without intravenous contrast to monitor her disease.In November 2009 (21 months after diagnosis), the patient developed abdominal bloating, early satiety, and right upper quadrant pain that increased with inspiration. Pulmonary exam demonstrated dullness ABSTRACT Pseudocirrhosis is a rare form of liver disease that can cause clinical symptoms and radiographic signs of cirrhosis; however, its histologic features suggest a distinct pathologic process. In the setting of cancer, hepatic metastases and systemic chemotherapy are suspected causes of pseudocirrhosis. Here, we present a patient with medullary thyroid carcinoma metastatic to the liver who developed pseudocirrhosis while on maintenance sunitinib after receiving 5-fluorouracil, leucovorin, and oxaliplatin (folfox) in combination with sunitinib. Cirrhotic change in liver morphology was accompanied by diffusely infiltrative carcinomatous disease resembling the primary tumor. We discuss the diagnosis of pseudocirrhosis in this case and review the literature regarding pseudocirrhosis in cancer. KEY WORDSMedullary thyroid cancer, pseudocirrhosis, carcinomatous cirrhosis CASE DESCRIPTIONA 49-year-old white woman presented in January 2008 with a left-sided cervical mass without associated complaints of neck pain, stridor, dysphonia, dysphagia, malaise, fever, or chills. Physical examination was remarkable for a f...

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“…However, systematic data on the hepatotoxic effects of chemotherapy are scant, and the mechanisms of injury are established for few agents. There are few reports of patients with liver metastasis who develop radiological finding mimicking cirrhosis, both in the presence or the absence of prior systemic chemotherapy [6][7][8]. This article reports a series of ten women with breast cancer (nine with liver metastasis) who received chemotherapy and hormonotherapy, in whom a cirrhosis-like pattern was seen on the computed tomography (CT) scan.…”

Section: Introductionmentioning

confidence: 99%