Escobar-Valdivia Emmanuel, Monreal-Robles Roberto, Delgado-García Guillermo, Hernández-Velazquez Badir
Department of Internal Medicine, Autonomous University of Nuevo Leon, Monterrey, Mexico.
Division of Gastroenterology, University Hospital, Autonomous University of Nuevo León.
Caspian J Intern Med. 2017 Winter;8(1):59-62.
Acute liver failure (ALF) as a consequence of metastatic disease is extremely uncommon. The liver is the most commonly affected organ by metastatic disease, but only a few cases of ALF in the setting of metastatic choroidal melanoma have been reported.
We describe the case of a 47-year-old man with right upper quadrant pain, progressive jaundice, and unintentional weight loss. He also reported that he had experienced reduced left visual acuity which progressed to blindness over 2 months. On physical examination, we found a pigmented scleral lesion in the left eye. He had a coagulopathy and during his hospital stay, he also developed encephalopathy. The diagnosis of ALF was therefore established and was later attributed to metastatic uveal melanoma. In addition, we briefly review the relevant literature.
Liver metastasis should be kept in mind when assessing abnormal liver function tests in patients with uveal malignant melanoma.
转移性疾病导致的急性肝衰竭（ALF）极为罕见。肝脏是转移性疾病最常累及的器官，但仅有少数转移性脉络膜黑色素瘤导致ALF的病例报道。
我们描述了一名47岁男性的病例，他有右上腹疼痛、进行性黄疸和非故意体重减轻。他还报告说，他的左眼视力下降，在2个月内逐渐发展为失明。体格检查时，我们在他的左眼发现了一个色素性巩膜病变。他存在凝血功能障碍，住院期间还出现了脑病。因此确诊为ALF，后来归因于转移性葡萄膜黑色素瘤。此外，我们简要回顾了相关文献。
在评估葡萄膜恶性黑色素瘤患者肝功能检查异常时，应考虑肝转移的可能性。
