Rapid hepatic failure associated with a contracted liver mimicking cirrhosis in a case of nasopharyngeal carcinoma with liver metastasis

Yue Ting Hwang, Pei Jer Chen, Jia Horng Kao, Tzung Dan Wang, Hsih Hsi Wang, Jan Show Chu, Ih Jen Su, Ding Shinn Chen

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9 Citations (Scopus)

Abstract

A 46-year-old women had an undifferentiated nonkeratinizing nasopharyngeal carcinoma, locally controlled by radiotherapy. Initially, she had normal liver function tests and normal hepatic ultrasonography. Seven months later, she experienced a rapidly progressive hepatic failure manifested by the development of ascites, elevation of serum bilirubin level, and prolongation of prothrombin time. Imaging studies showed a contracted liver and serum biochemical tests were compatible with chronic liver disease, except for an increase of alkaline phosphatase and γ-glutamyl transpeptidase levels. An endoscopic retrograde cholangiogram was compatible with changes of sclerosing cholangitis. The patient died of hepatic decompensation within two months. A liver necropsy disclosed diffuse infiltration of carcinoma cells into the hepatic sinusoids and obliterative angio-invasion of the tumor cells with massive fibrotic stroma replacing almost all hepatocytes. In situ hybridization demonstrated expression of Epstein-Barr virus transcripts EBER1 in the tumor cells and proved a metastatic nasopharyngeal carcinoma. The contracted liver is likely to be explained by the tumor-associated desmoplastic change and the obliterative angio-invasion of the tumor. It is important to be aware that, although rare, such an unusual pattern of liver metastasis may mimick cirrhosis clinically and cause rapid hepatic failure in patients with nasopharyngeal carcinoma.

Original languageEnglish
Pages (from-to)283-287
Number of pages5
JournalLiver
Volume16
Issue number4
Publication statusPublished - 1996
Externally publishedYes

Keywords

  • Hepatic failure
  • Infiltrative liver metastasis
  • Nasopharyngeal carcinoma
  • Sclerosing cholangitis

ASJC Scopus subject areas

  • Hepatology

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  • Cite this

    Hwang, Y. T., Chen, P. J., Kao, J. H., Wang, T. D., Wang, H. H., Chu, J. S., Su, I. J., & Chen, D. S. (1996). Rapid hepatic failure associated with a contracted liver mimicking cirrhosis in a case of nasopharyngeal carcinoma with liver metastasis. Liver, 16(4), 283-287.