Acute liver failure - chemotherapy induced

Case contributed by Levon Davtyan


RUQ pain. History of breast cancer, underwent segmental resection of the breast, radiotherapy, and chemotherapy.

Patient Data

Age: 40 years
Gender: Female

Initial CT


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. 

1 month later

  • 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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.