Faculty of Medicine, Vincent's Clinical School, University of New South Wales, Sydney, Australia.
Department of Gastroenterology and Hepatology, Vincent's Hospital, Sydney, Australia.
Clin J Gastroenterol. 2024 Dec;17(6):1125-1129. doi: 10.1007/s12328-024-02039-1. Epub 2024 Sep 17.
Acute liver failure secondary to metastatic melanoma is exceedingly rare with the literature limited to case reports. The disease itself presents with vague symptoms making diagnosis difficult without a high clinical suspicion. Further to this, the prognosis of acute liver failure secondary to metastatic melanoma is dismal. We present the case of a 59-year-old male with a distant history of previously excised cutaneous melanoma who presented to our institution with abdominal pain and liver enzyme derangement suggestive of acute hepatitis. Due to progressive derangement in liver function and cross-sectional imaging suggestive of an infiltrative cause, a left axillary lymph node was biopsied which demonstrated metastatic melanoma. The patient subsequently deteriorated into acute liver failure and despite acute treatment of his underlying metastatic melanoma died 17 days post initial presentation. This case highlights an uncommon cause of acute liver failure as well as the poor prognosis associated with acute liver failure secondary to metastatic melanoma.
继发于转移性黑色素瘤的急性肝衰竭极为罕见，文献仅限于病例报告。该病本身的症状较为模糊，如果没有高度的临床怀疑，诊断较为困难。除此之外，继发于转移性黑色素瘤的急性肝衰竭的预后极差。我们报告了一例 59 岁男性患者，其既往有已切除的皮肤黑色素瘤病史，因腹痛和肝功能酶异常就诊于我院，提示急性肝炎。由于肝功能进行性恶化，且横断面成像提示浸润性病因，对左侧腋窝淋巴结进行了活检，结果显示为转移性黑色素瘤。患者随后发展为急性肝衰竭，尽管对其基础转移性黑色素瘤进行了急性治疗，但在初次就诊后 17 天死亡。本病例突出了急性肝衰竭的一种不常见病因，以及继发于转移性黑色素瘤的急性肝衰竭的不良预后。
