Massive liver necrosis associated with hyperamylasemia

In North America, massive liver necrosis is due mainly to viral infection or exposure to hepatotoxins. We report an unusual case of massive liver necrosis due to diffuse liver infiltration by small cell carcinoma of the lung. The unusual presentation included hyperamylasemia due to ectopic amylase production by the tumor. In this era of liver transplantation it is important to consider malignancy in the differential diagnosis of fulminant or acute liver failure prior to liver transplantation.