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Fatty metamorphosis of the liver in malignant neoplasia. Special reference to carcinoma of the breast
Author(s) -
Lanza Frank L.,
Nelson Robert S.
Publication year - 1968
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(196804)21:4<699::aid-cncr2820210422>3.0.co;2-5
Subject(s) - medicine , autopsy , metamorphosis , cancer , biopsy , fatty liver , carcinoma , pathology , breast cancer , liver biopsy , gastroenterology , disease , biology , botany , larva
Fatty metamorphosis of the liver was found in an unusually large number of percutaneous needle liver biopsies in patients having mammary carcinoma with suspected metastases; this prompted a study of this abnormality in patients with cancer in general. The autopsy records of 1744 patients and percutaneous liver biopsy reports of 489 patients with malignant neoplasia were reviewed. Fatty metamorphosis was found in 66 (2.8%) of autopsies and 36 (7.3%) of liver biopsies. In cancer of the breast the incidence of fatty metamorphosis on biopsy (21.0%) exceeded that for all other cancers combined or for any other single tumor type, while at autopsy the frequency (5.9%) exceeded that of all other cancers (3.5%). In both autopsy and biopsy series there was a fatty metamorphosis ratio of 2:1 female to male patients. Of the 14 patients having mammary cancer with fatty metamorphosis on biopsy, 11 had hepatomegaly and all but one had abnormal bromsulfalein retention. Alkaline phosphatase was elevated in four, three of whom had metastases to bone. Seven of the 14 were obese and four had been treated with chemotherapeutic agents or had undergone oophorectomy. Four were diabetic; three had received steroids or androgens; one had received estrogens and one was clinically malnourished. Rebiopsy at 24 to 44 months showed no change in three and mild fibrosis in one. There is a definite increase in fatty metamorphosis of the liver in patients with carcinoma of the breast, which may account for hepatomegaly with bromsulfalein retention in such cases and be confused with metastases to the liver. The cause for this finding is unknown.