Last revised by Mohammad Taghi Niknejad on 4 Jan 2024

Pseudocirrhosis is a radiological term used to convey the imaging findings of cirrhosis but emphasizes that it occurs in the setting of hepatic metastases. It is most commonly reported following chemotherapeutic treatment of breast cancer metastases, although it has also been reported before treatment and with other malignancies, including pancreatic cancer, colon cancer, medullary thyroid cancer and esophageal cancer 5.

The term "pseudocirrhosis" is intended to convey a different disease process compared with cirrhosis of chronic liver disease.

Although most cases are mainly identified on an imaging basis, particularly found on post-treatment surveillance scans, patients may have symptoms related to liver failure and portal hypertension, including abdominal distension due to ascites

Two pathophysiologic correlates of pseudocirrhosis have been described 4:

  • hepatic capsular retraction in response to chemotherapeutic agents, with nodular regenerative hyperplasia and absence of bridging fibrosis or cirrhosis on histopathology

  • extensive fibrosis representing a profound desmoplastic response to an infiltrating tumor, occurring prior to chemotherapy

Imaging manifestations on CT, ultrasound, and MRI may be identical to liver cirrhosis, and consist of:

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