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Pseudocirrhosis is a radiological term used to convey the imaging findings of cirrhosis, but emphasize that it occurs in the setting of hepatic metastases. It is most commonly reported following chemotherapeutic treatment of breast cancer metastases, although has also been reported before treatment, and with other malignancies 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:
- 1. Lee SL, Chang ED, Na SJ et-al. Pseudocirrhosis of breast cancer metastases to the liver treated by chemotherapy. Cancer Res Treat. 2014;46 (1): 98-103. doi:10.4143/crt.2014.46.1.98 - Free text at pubmed - Pubmed citation
- 2. Jeong WK, Choi SY, Kim J. Pseudocirrhosis as a complication after chemotherapy for hepatic metastasis from breast cancer. Clin Mol Hepatol. 2013;19 (2): 190-4. doi:10.3350/cmh.2013.19.2.190 - Free text at pubmed - Pubmed citation
- 3. Jha P, Poder L, Wang ZJ et-al. Radiologic mimics of cirrhosis. AJR Am J Roentgenol. 2010;194 (4): 993-9. doi:10.2214/AJR.09.3409 - Pubmed citation
- 4. David A. Sass, Kenneth Clark, Dana Grzybicki, Mordechai Rabinovitz, Thomas A. Shaw-Stiffel. Diffuse Desmoplastic Metastatic Breast Cancer Simulating Cirrhosis with Severe Portal Hypertension: A Case of “Pseudocirrhosis”. (2007) Digestive Diseases and Sciences. 52 (3): 749. doi:10.1007/s10620-006-9332-9 - Pubmed
- 5. Adike A, Karlin N, Menias C, Carey EJ. Pseudocirrhosis: A Case Series and Literature Review. (2016) Case reports in gastroenterology. 10 (2): 381-391. doi:10.1159/000448066 - Pubmed