Presentation
RUQ pain. History of breast cancer, underwent segmental resection of the breast, radiotherapy, and chemotherapy.
Patient Data
Age: 40 years
Gender: Female
Axial C+ portal venous phase
There is no liver metastasis and/or parenchymal heterogeneity. Few minute cysts are only noted. No ascites.
1 month later during chemotherapy, the patient presented with RUQ pain with elevated liver enzymes and inflammatory markers.
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Axial C+ arterial phase
- The liver is markedly enlarged and has a craniocaudal dimension of 24 cm
- Hepatic parenchymal heterogeneity is visible on contrast-enhanced CT scans
- The gallbladder wall is mildly thickened with pericholecystic fluid
- Mild pelvic and perihepatic ascites
- Hepatic simple cysts are visible in segment VI
- Right breast segmental resection and mediastinal lymphadenopathy
- Mild right-sided pleural effusion
- Hypodense metastatic lesions in the left femoral head (white arrow) and vertebrae (not shown)
Case Discussion
Here is a case of acute liver failure after chemotherapy with metastases from breast cancer affecting the lungs, bones, and mediastinal lymph nodes. Acute liver failure has a high mortality (~50%). Unfortunately, the patient passed after two days.