Cancer Res Treat.  2014 Jan;46(1):98-103.

Pseudocirrhosis of Breast Cancer Metastases to the Liver Treated by Chemotherapy

• Lee SL
• Chang ED
• Na SJ
• Kim JS
• An HJ
• Ko YH
• Won HS

Abstract

Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.

Keyword

Pseudocirrhosis; Breast neoplasms; Drug therapy

MeSH Terms

Biopsy
Breast Neoplasms*
Breast*
Decompression
Disease Progression
Drug Therapy*
Electrons
Fibrosis
Humans
Hypertension, Portal
Liver*
Neoplasm Metastasis*
Prognosis

Figure

• 

  Fig. 1 Serial radiologic images of breast cancer with multiple liver metastases. (A, B) Contrast enhanced computed tomography (CT) scan (March 29, 2005) shows no evidence of liver metastasis or surface nodularity of the liver. (C, D) Contrast enhanced CT scan (September 22, 2011) shows multiple liver metastases in the liver, but no evidence of surface nodularity and esophageal varices. (E, F) Contrast enhanced CT scan (April 2, 2012) shows multiple liver metastases and a cirrhosis like appearance, such as surface nodularity (arrows), esophageal varices (arrowhead), and ascites (★).

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  Fig. 2 F18 fluorodeoxyglucose positron emission tomography/computed tomography images taken on April 3, 2012. Axial positron emission tomography (A, C) and fusion (B, D) images show diffusely and heterogeneously increased activity in known hepatic metastases. Maximum intensity projection image (E) also shows extensive hepatic metastasis. Focally and incidentally increased activity (arrow) is seen in an abscess of the left mandible.

• 

  Fig. 3 (A, B) Diffusely infiltrated carcinoma cells with extensive fibrosis in liver parenchyma (H&E staining, ×200). Positive immunohistochemical staining for MOC 31 (C; ×200) and estrogen receptor (D; ×200).

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