Sudden onset acute liver failure in a patient with clinically occult small cell lung carcinoma: autopsy report and review of the medical literature

Abstract

Liver metastases are commonly found in advanced cancer patients; however, acute liver failure secondary to diffuse liver infiltration is rare. Small cell lung carcinoma accounts for 15% of lung carcinomas. We describe the ninth case of small cell lung carcinoma massively metastatic to the liver, reported in the scientific literature, with sudden clinical onset and death after a few days. An autopsy was performed to understand the cause of death.

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“…In small cell lung cancer, there are many cases where patients have no symptoms of metastatic disease only to progress to death extremely quickly, sometimes within a week of onset of any symptom at all. For example, Figure 1.4 shows the liver of a patient with small cell lung cancer that presented with liver failure only nine days before death (Guerriero et al, 2019). The liver in this example was completely infiltrated by the lung metastatic cells, with only thin cords of hepatocytes remaining.…”