Complete recovery from pseudocirrhosis caused by chemotherapy for diffuse liver metastases of breast cancer.

Abstract

Pseudocirrhosis refers to morphologic changes of the liver seen radiographically that mimic cirrhosis and arise in the setting of metastatic malignancy. Like true cirrhosis, pseudocirrhosis causes portal hypertension, which can lead to complications such as ascites and esophageal varices. We experienced a case of pseudocirrhosis that occurred during treatment for diffuse liver metastases from breast cancer. Pseudocirrhosis is often caused by diffuse hepatic cancer cell infiltration; however, in this case, it still occurred despite chemotherapy being effective. The shrinkage of liver metastases and subsequent scarring around them causes liver capsule regression, resulting in pseudocirrhotic changes. As a result of treatment for pseudocirrhosis, the once-atrophied liver regenerated and returned to its normal size after a year. Ascites and edema as portal pressure complications also disappeared. During this time, the liver metastases maintained a near-complete response. Cirrhosis accompanied by ascites is usually called "decompensated cirrhosis" and is considered difficult to improve; however, in pseudocirrhosis, the liver can regenerate and the patient can recover. Physicians must be fully aware of this disease.