Malignant infiltration of the liver presenting as acute liver failure

Nicole E. Rich, Corron Sanders, Randall S. Hughes, Robert J. Fontana, R. Todd Stravitz, Oren Fix, Steven H. Han, Willscott E. Naugler, Atif Zaman, William M. Lee

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


There have been few reports of acute liver failure (ALF), with encephalopathy and coagulopathy, caused by infiltration of the liver by malignant cells. We describe a case series of 27 patients with ALF caused by malignancy. We examined a large, multicenter ALF registry (1910 patients; mean age, 47.1 ± 13.9 y) and found only 27 cases (1.4%) of ALF attributed to malignancy. Twenty cases (74%) presented with abdominal pain and 11 presented with ascites. The most common malignancies included lymphoma or leukemia (33%), breast cancer, (30%), and colon cancer (7%); 90% of the patients with lymphoma or leukemia had no history of cancer, compared with 25% of patients with breast cancer. Overall, 44% of the patients had evidence of liver masses on imaging. Diagnosis was confirmed by biopsy in 15 cases (55%) and by autopsy for 6 cases. Twenty-four patients (89%) died within 3 weeks of ALF.

Original languageEnglish (US)
Pages (from-to)1025-1028
Number of pages4
JournalClinical Gastroenterology and Hepatology
Issue number5
StatePublished - May 1 2015


  • Acute liver failure
  • Liver transplantation
  • Malignancy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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