Pseudocirrhosis

Case contributed by Dr Matt A. Morgan

Presentation

Routine oncologic follow up. Asymptomatic.

Patient Data

Age: 55 years

Pseudocirrhosis

CT

Diffusely nodular appearance of the liver with pronounced areas of capsular retraction.

There is no splenomegaly, no development of portal venous collaterals, and no ascites.

Case Discussion

The patient above had been treated for her metastatic breast cancer with multiple different chemotherapy agents. She had no history of liver disease.

Pseudocirrhosis may be seen in patients who undergo chemotherapy. It is most common with breast cancer, but has also been reported to occur with treatment for carcinoid tumor and Hodgkin disease.

Pseudocirrhosis is thought to be caused by two factors

  • hepatic irregularity/retraction from a decrease in size of extensive metastatic disease in the liver
  • regenerative nodules, altering the liver surface

A type of "pseudocirrhosis" may also occur from widespread metastatic disease without chemotherapy response, but the lack of enhancement with treatment-response "pseudocirrhosis" is usually more of a diagnostic dilemma.

To confuse the issue, ascites and splenomegaly may occur with pseudocirrhosis, so the history of chemotherapy is essential to make a diagnosis.

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