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Fulminant Malignant Hepatic Failure

Javier Munoz, Jawad Sheqwara, Amr Hanbali and Ira Wollner

We present a patient that developed abdominal pain, jaundice and confusion leading to a diagnosis of metastatic disease to the liver. Our case is a reminder of the possibility of malignancy in the differential diagnosis of fulminant liver failure. The liver is a common destination for metastatic malignant spread nevertheless, metastatic fulminant liver failure is a rare occurrence and when it develops is usually hematological in nature. Prognosis has remained poor over the last decades as most patients have a fatal outcome within days after their admission to the hospital for work-up of hyperbilirubinemia. Malignant hepatic infiltration should be considered in the differential diagnosis of acute progressive liver failure.