Department of Medicine III, University Hospital, LMU, Munich, Germany;
Department of Medicine V, University Hospital, LMU, Munich, Germany.
Anticancer Res. 2024 Sep;44(9):4127-4132. doi: 10.21873/anticanres.17242.
Acute liver failure (ALF) secondary to metastatic melanoma presents a rare and diagnostically challenging clinical scenario.
We report the case of a 57-year-old male who succumbed to fulminant liver failure attributed to hepatic infiltration by malignant melanoma. Despite extensive diagnostic evaluation, the underlying cause of ALF remained elusive until postmortem examination revealed multifocal metastatic melanoma. Notably, the autopsy disclosed a remarkable finding: a 10 cm lymph node in the right axilla, conspicuously harboring metastatic melanoma cells. Surprisingly, this progressive lymph node was not detected on admission or during comprehensive imaging studies conducted 24 h prior to death. Rigorous cross-referencing of radiological and autopsy findings highlighted the accuracy of prior interventions visible on imaging, further accentuating the dynamic nature of metastatic melanoma progression.
This case underscores the importance of vigilance in detecting metastatic melanoma, even in atypical sites, and emphasizes the need for multidisciplinary collaboration in complex clinical scenarios.
转移性黑色素瘤导致的急性肝衰竭（ALF）是一种罕见且具有挑战性的临床情况。
我们报告了一例 57 岁男性病例，他因恶性黑色素瘤肝浸润而死于暴发性肝衰竭。尽管进行了广泛的诊断评估，但 ALF 的根本原因仍未明确，直到尸检显示多灶性转移性黑色素瘤。值得注意的是，尸检揭示了一个显著的发现：右腋窝有一个 10 厘米的淋巴结，明显含有转移性黑色素瘤细胞。令人惊讶的是，这个进行性的淋巴结在入院时或在死亡前 24 小时进行的全面影像学研究中都没有被检测到。对影像学和尸检结果的严格交叉参考突出了之前影像学上可见干预措施的准确性，进一步强调了转移性黑色素瘤进展的动态性质。
本病例强调了即使在非典型部位也要警惕检测转移性黑色素瘤的重要性，并强调了在复杂临床情况下需要多学科合作。
