PubMed ID:
25277846
Public Release Type:
Journal
Publication Year: 2015
Affiliation: Division of Gastroenterology and Hepatology, The University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: William.lee@UTSouthwestern.edu.
DOI:
https://doi.org/10.1016/j.cgh.2014.09.040
Authors:
Fontana RJ,
Lee WM,
Stravitz RT,
Fix O,
Han SH,
Hughes RS,
Naugler WE,
Rich NE,
Sanders C,
Zaman A
Studies:
Acute Liver Failure Study Group: Adult Acute Liver Failure Study
There have been few reports of acute liver failure (ALF), with encephalopathy and coagulopathy, caused by infiltration of the liver by malignant cells. We describe a case series of 27 patients with ALF caused by malignancy. We examined a large, multicenter ALF registry (1910 patients; mean age, 47.1 ± 13.9 y) and found only 27 cases (1.4%) of ALF attributed to malignancy. Twenty cases (74%) presented with abdominal pain and 11 presented with ascites. The most common malignancies included lymphoma or leukemia (33%), breast cancer, (30%), and colon cancer (7%); 90% of the patients with lymphoma or leukemia had no history of cancer, compared with 25% of patients with breast cancer. Overall, 44% of the patients had evidence of liver masses on imaging. Diagnosis was confirmed by biopsy in 15 cases (55%) and by autopsy for 6 cases. Twenty-four patients (89%) died within 3 weeks of ALF.