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Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis

A 70-year-old female with a history of lobular carcinoma of the breast, status post-mastectomy followed by adjuvant radio-chemotherapy in remission for 4 years was admitted with the features of acute liver failure (ALF). Iron studies revealed a hemochromatosis picture and the CT and MRI scans of the...

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Autores principales: Chandradevan, Raguraj, Takeda, Hironobu, Hayes, Benjamin, Faulkner, Kalli, Darrow, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202048/
https://www.ncbi.nlm.nih.gov/pubmed/32395253
http://dx.doi.org/10.1093/omcr/omaa019
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author Chandradevan, Raguraj
Takeda, Hironobu
Hayes, Benjamin
Faulkner, Kalli
Darrow, Matthew
author_facet Chandradevan, Raguraj
Takeda, Hironobu
Hayes, Benjamin
Faulkner, Kalli
Darrow, Matthew
author_sort Chandradevan, Raguraj
collection PubMed
description A 70-year-old female with a history of lobular carcinoma of the breast, status post-mastectomy followed by adjuvant radio-chemotherapy in remission for 4 years was admitted with the features of acute liver failure (ALF). Iron studies revealed a hemochromatosis picture and the CT and MRI scans of the abdomen suggested cirrhosis. An extensive workup failed to identify an etiology. A trans-jugular liver biopsy was obtained and revealed poorly differentiated carcinoma consistent with the metastasis of breast primary. The patient’s condition deteriorated and died within a week following the onset of acute hepatic failure. DNA testing revealed that the patient was heterozygous for H63D mutation. In cases of ALF with the suspicion of malignancy, liver biopsy should be obtained to evaluate an infiltrative hepatic disease.
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spelling pubmed-72020482020-05-11 Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis Chandradevan, Raguraj Takeda, Hironobu Hayes, Benjamin Faulkner, Kalli Darrow, Matthew Oxf Med Case Reports Case Report A 70-year-old female with a history of lobular carcinoma of the breast, status post-mastectomy followed by adjuvant radio-chemotherapy in remission for 4 years was admitted with the features of acute liver failure (ALF). Iron studies revealed a hemochromatosis picture and the CT and MRI scans of the abdomen suggested cirrhosis. An extensive workup failed to identify an etiology. A trans-jugular liver biopsy was obtained and revealed poorly differentiated carcinoma consistent with the metastasis of breast primary. The patient’s condition deteriorated and died within a week following the onset of acute hepatic failure. DNA testing revealed that the patient was heterozygous for H63D mutation. In cases of ALF with the suspicion of malignancy, liver biopsy should be obtained to evaluate an infiltrative hepatic disease. Oxford University Press 2020-05-06 /pmc/articles/PMC7202048/ /pubmed/32395253 http://dx.doi.org/10.1093/omcr/omaa019 Text en © The Author(s) 2020. Published by Oxford University Press. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Chandradevan, Raguraj
Takeda, Hironobu
Hayes, Benjamin
Faulkner, Kalli
Darrow, Matthew
Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis
title Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis
title_full Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis
title_fullStr Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis
title_full_unstemmed Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis
title_short Metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis
title_sort metastatic breast cancer presenting as acute liver injury: diagnostic dilemma in the setting of suspected hemochromatosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202048/
https://www.ncbi.nlm.nih.gov/pubmed/32395253
http://dx.doi.org/10.1093/omcr/omaa019
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