Te H S, Schiano T D, Kahaleh M, Lissoos T W, Baker A L, Hart J, Conjeevaram H S
Department of Pathology, University of Chicago Hospitals, Illinois 60637, USA.
Am J Gastroenterol. 1999 Jan;94(1):262-6. doi: 10.1111/j.1572-0241.1999.00811.x.
Malignant melanoma has a propensity to metastasize widely to many organs, involving the liver in up to one-third of cases. Fulminant hepatic failure is an unusual presentation of hepatic neoplasms, whether primary or metastatic. We describe a case of malignant melanoma with liver metastases that rapidly progressed to fulminant hepatic failure and death. Striking elevations of liver tests, particularly lactate dehydrogenase, were seen. Liver biopsy showed diffuse intrasinusoidal infiltration with melanoma cells. In patients with malignant melanoma, raised serum lactate dehydrogenase levels may suggest hepatic involvement, with extreme elevations possibly predictive of liver failure.
恶性黑色素瘤易于广泛转移至多个器官，高达三分之一的病例会累及肝脏。暴发性肝衰竭是肝脏肿瘤（无论是原发性还是转移性）的一种不常见表现。我们描述了一例伴有肝转移的恶性黑色素瘤病例，该病例迅速进展为暴发性肝衰竭并导致死亡。观察到肝功能检查显著升高，尤其是乳酸脱氢酶。肝活检显示黑色素瘤细胞弥漫性窦内浸润。在恶性黑色素瘤患者中，血清乳酸脱氢酶水平升高可能提示肝脏受累，极度升高可能预示肝衰竭。
