Chemotherapy-related hepatotoxicity causing imaging findings resembling cirrhosis

In this article, we describe three women in whom changes in the liver resembling cirrhosis occurred during systemic chemotherapy for metastatic breast carcinoma. All three patients were treated with tamoxifen as part of their chemotherapeutic regimen. Abnormalities of biochemical liver tests were associated with the development of a cirrhosis-like appearance of the liver on computed tomography. In two of the patients, hepatic metastases were proved at biopsy. The third patient had no radiologic evidence of metastatic disease. Chemotherapy for metastatic breast carcinoma may cause striking morphologic changes in the liver that resemble cirrhosis. Of importance, these changes should not be mistaken for the development or progression of liver metastases. Alternatively, because of the changes produced by chemotherapeutic agents, detection of metastases on computed tomography alone may be more difficult. Supplementary magnetic resonance imaging may be helpful in selected cases.