Pseudocirrhosis Due to Desmoplastic Response to Chemotherapy in Breast Cancer Liver Metastases

Pseudocirrhosis can result in cirrhosis-like symptoms of portal hypertension and is observed mostly in patients with breast cancer; however, its cause is unclear. Herein, we report a case of pseudocirrhosis in a 76-year-old woman with metastatic breast cancer. The patient developed irregular contours of the liver, resembling cirrhosis, and esophageal varices during chemotherapy for breast cancer with liver metastases. Although intrahepatic metastasis was absent on imaging, a liver biopsy showed cancer cell infiltration consistent with the fibrotic area, which was similar to fibrosis seen in liver cirrhosis. Endoscopic ligation was performed for the varices; however, the patient's worsening liver function made it difficult to continue chemotherapy. Clinicians should be alert to the possibility of pseudocirrhosis developing in patients with metastatic breast cancer undergoing chemotherapy. Since pseudocirrhosis is a life-threatening complication, non-invasive markers for early diagnosis are needed.