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Published on: October 24, 2015
Metastatic prostatic carcinoma presenting as fulminant hepatic failure
Faiz A Shakir1, Mohammed Madhoun, Joshua Whorton
1Department of Internal Medicine, Section of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. faiz-shakir@ouhsc.edu
Southern Medical Journal
|September 16, 2008
Summary
Fulminant hepatic failure, a rare complication of metastatic prostate cancer, can rapidly lead to death. Early suspicion and palliative chemotherapy are crucial for managing this aggressive presentation.
Area of Science:
- Oncology
- Hepatology
Background:
- Metastatic prostate carcinoma typically presents with urinary or bone symptoms.
- Rapidly progressive liver failure is an uncommon manifestation of advanced prostate cancer.
Observation:
- A 68-year-old male with metastatic prostate cancer developed severe abdominal pain, dyspnea, and confusion.
- Elevated liver enzymes, creatine phosphokinase, and prostate-specific antigen (PSA) were noted.
- The patient experienced rapid deterioration, culminating in fulminant hepatic failure and death.
Findings:
- Autopsy revealed extensive hepatic necrosis.
- Metastatic prostatic carcinoma cells extensively infiltrated the liver parenchyma and vasculature.
- The patient's elevated bilirubin levels peaked at 8.5 mg/dL.
Implications:
- Fulminant hepatic failure necessitates a high index of suspicion in patients with advanced prostate cancer.
- Palliative chemotherapy should be considered for patients presenting with this rare, aggressive complication.
- This case highlights the critical need for prompt diagnosis and management of metastatic prostate cancer complications.
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