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Acute liver failure due to radiographically occult infiltration of urothelial cancer

INTRODUCTION: Acute liver failure (ALF) due to diffuse infiltrating solid malignancy without any focal lesions on radiographic imaging is rare. CASE REPORT: A 70-year-old man was admitted due to mental confusion, abdominal pain, and ALF. Three years before, he had undergone a left nephrectomy for ur...

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Autores principales: Tosatto, Valentina, Pimentel, João Cabral, Cruz, Cristiano, Almeida, André, Boattini, Matteo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hospital Universitário da Universidade de São Paulo 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214878/
https://www.ncbi.nlm.nih.gov/pubmed/34307219
http://dx.doi.org/10.4322/acr.2021.256
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author Tosatto, Valentina
Pimentel, João Cabral
Cruz, Cristiano
Almeida, André
Boattini, Matteo
author_facet Tosatto, Valentina
Pimentel, João Cabral
Cruz, Cristiano
Almeida, André
Boattini, Matteo
author_sort Tosatto, Valentina
collection PubMed
description INTRODUCTION: Acute liver failure (ALF) due to diffuse infiltrating solid malignancy without any focal lesions on radiographic imaging is rare. CASE REPORT: A 70-year-old man was admitted due to mental confusion, abdominal pain, and ALF. Three years before, he had undergone a left nephrectomy for urothelial carcinoma followed by adjuvant chemotherapy. The abdominal computed tomography (CT) showed hepatomegaly and ascites. Ascitic fluid had transudate characteristics, with no malignant cells. Percutaneous liver biopsy (LB) showed diffuse liver infiltration of metastatic urothelial carcinoma. The patient rapidly deteriorated and died in a week due to ALF. DISCUSSION: History of solid cancer and hepatomegaly and/or liver failure without other obvious explanation should encourage to perform LB. CONCLUSION: LB is warranted to avoid misdiagnosis, prolonged hospital stays, and delay in palliative care.
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spelling pubmed-82148782021-07-23 Acute liver failure due to radiographically occult infiltration of urothelial cancer Tosatto, Valentina Pimentel, João Cabral Cruz, Cristiano Almeida, André Boattini, Matteo Autops Case Rep Clinical Case Report INTRODUCTION: Acute liver failure (ALF) due to diffuse infiltrating solid malignancy without any focal lesions on radiographic imaging is rare. CASE REPORT: A 70-year-old man was admitted due to mental confusion, abdominal pain, and ALF. Three years before, he had undergone a left nephrectomy for urothelial carcinoma followed by adjuvant chemotherapy. The abdominal computed tomography (CT) showed hepatomegaly and ascites. Ascitic fluid had transudate characteristics, with no malignant cells. Percutaneous liver biopsy (LB) showed diffuse liver infiltration of metastatic urothelial carcinoma. The patient rapidly deteriorated and died in a week due to ALF. DISCUSSION: History of solid cancer and hepatomegaly and/or liver failure without other obvious explanation should encourage to perform LB. CONCLUSION: LB is warranted to avoid misdiagnosis, prolonged hospital stays, and delay in palliative care. Hospital Universitário da Universidade de São Paulo 2021-03-12 /pmc/articles/PMC8214878/ /pubmed/34307219 http://dx.doi.org/10.4322/acr.2021.256 Text en Copyright © 2021 The Author(s). https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Case Report
Tosatto, Valentina
Pimentel, João Cabral
Cruz, Cristiano
Almeida, André
Boattini, Matteo
Acute liver failure due to radiographically occult infiltration of urothelial cancer
title Acute liver failure due to radiographically occult infiltration of urothelial cancer
title_full Acute liver failure due to radiographically occult infiltration of urothelial cancer
title_fullStr Acute liver failure due to radiographically occult infiltration of urothelial cancer
title_full_unstemmed Acute liver failure due to radiographically occult infiltration of urothelial cancer
title_short Acute liver failure due to radiographically occult infiltration of urothelial cancer
title_sort acute liver failure due to radiographically occult infiltration of urothelial cancer
topic Clinical Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8214878/
https://www.ncbi.nlm.nih.gov/pubmed/34307219
http://dx.doi.org/10.4322/acr.2021.256
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