Abstract
A 57-year-old woman presented with a right breast mass. A contrast-enhanced computed tomography (CT) scan revealed a 3 cm tumor of the right breast and axillary lymphadenopathy. She was diagnosed with invasive ductal carcinoma, stage IIB (T2N1M0), by a core needle biopsy of the breast. After preoperative chemotherapy (FEC × 4, paclitaxel × 9), a CT scan taken just before surgery showed a partial response of the breast tumor without distant metastasis. Nine months after the first visit, she underwent mastectomy and axillary lymph node dissection. After the surgery, she was started on exemestane. Three weeks later, she was admitted to our hospital because of abdominal pain. We suspected a drug-induced liver failure because her laboratory examination showed high levels of hepatobiliary enzymes, and a CT scan revealed hepatomegaly with contrast heterogeneity. Her condition rapidly deteriorated and she died within 12 days of admission (65 days after the operation). Most of her hepatocytes were found to be replaced by tumor cells in the postmortem liver needle biopsy, and she was diagnosed with acute liver failure due to diffuse liver metastases. We report our experience with a case of diffuse liver metastases of breast cancer with very rapid progression.
