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- Case Report -

A Case of Small Cell Lung Cancer Presenting with Severe Liver Injury due to Diffuse Liver Metastases Which Was Successfully Treated with Early Chemotherapy

Kenji Morimoto¹, Yoshie Morimoto¹, Rie Yoshida², Koji Date², Hidehiko Kawano², Koichi Takayama^1
1Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan, ²Department of Pulmonary Medicine, Kyoto Chubu Medical Center, Japan

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Background. Small cell lung cancer is prone to be associated with liver metastases, but it rarely leads to diffuse liver metastases with severe liver damage. The prognosis of severe liver damage is extremely poor and chemotherapy is rarely available for this condition. Case. A 61-year-old man presented with abdominal distension. Blood test results showed marked liver dysfunction and contrast-enhanced computed tomography (CT) showed a nodule in the lower lobe of the left lung, mediastinal lymphadenopathy, and marked hepatomegaly with diffuse nodular lesions. We performed endobronchial ultrasound-guided transbronchial needle aspiration in the enlarged mediastinal lymph node. The histopathological examination confirmed the presence of metastatic small cell carcinoma. The patient received treatment with cisplatin plus etoposide and showed a partial response. CT after chemotherapy revealed a lobular liver surface which mimicked the appearance of liver cirrhosis; therefore, we made a diagnosis of pseudocirrhosis by excluding any other causes. We continued to perform chemotherapy until the disease progressed, while paying attention to any complications associated with liver cirrhosis. Conclusion. An early diagnosis and chemotherapy are beneficial for the treatment of small cell lung cancer with severe liver damage due to liver metastases.
key words: Hepatomegaly, Diffuse liver metastases, Small cell lung cancer, Pseudocirrhosis

Received: May 1, 2020
Accepted: June 1, 2020

JJLC 60 (5): 396-400, 2020