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乳腺癌肝转移化疗后促结缔组织增生反应所致假肝硬化

Pseudocirrhosis Due to Desmoplastic Response to Chemotherapy in Breast Cancer Liver Metastases.

作者信息

Takata Kazuhide, Mogi Ai, Yamauchi Ryo, Shakado Satoshi, Hirai Fumihito

机构信息

Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, JPN.

Division of Medical Oncology, Hematology and Infectious Disease, Department of Internal Medicine, Fukuoka University Faculty of Medicine, Fukuoka, JPN.

出版信息

Cureus. 2022 May 25;14(5):e25321. doi: 10.7759/cureus.25321. eCollection 2022 May.

Abstract

Pseudocirrhosis can result in cirrhosis-like symptoms of portal hypertension and is observed mostly in patients with breast cancer; however, its cause is unclear. Herein, we report a case of pseudocirrhosis in a 76-year-old woman with metastatic breast cancer. The patient developed irregular contours of the liver, resembling cirrhosis, and esophageal varices during chemotherapy for breast cancer with liver metastases. Although intrahepatic metastasis was absent on imaging, a liver biopsy showed cancer cell infiltration consistent with the fibrotic area, which was similar to fibrosis seen in liver cirrhosis. Endoscopic ligation was performed for the varices; however, the patient's worsening liver function made it difficult to continue chemotherapy. Clinicians should be alert to the possibility of pseudocirrhosis developing in patients with metastatic breast cancer undergoing chemotherapy. Since pseudocirrhosis is a life-threatening complication, non-invasive markers for early diagnosis are needed.

摘要

假肝硬化可导致门静脉高压的肝硬化样症状,多见于乳腺癌患者;然而,其病因尚不清楚。在此,我们报告一例76岁转移性乳腺癌女性患者的假肝硬化病例。该患者在接受肝转移乳腺癌化疗期间出现肝脏轮廓不规则,类似肝硬化,以及食管静脉曲张。尽管影像学检查未发现肝内转移,但肝脏活检显示癌细胞浸润与纤维化区域一致,类似于肝硬化中的纤维化。对静脉曲张进行了内镜结扎;然而,患者肝功能恶化使得继续化疗变得困难。临床医生应警惕接受化疗的转移性乳腺癌患者发生假肝硬化的可能性。由于假肝硬化是一种危及生命的并发症,因此需要早期诊断的非侵入性标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7600/9236629/c81d14f94dcf/cureus-0014-00000025321-i01.jpg

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