Radiographically Occult Carcinomatous Spread of Breast Cancer to the Liver: A Challenging Case

Table 1

Summary of literature reports of diffuse and/or occult liver involvement by metastatic breast cancer.

Authors	Age	Receptors	Concurrent diagnoses/presentation/notes	E-cad loss	Imaging	Time from 1° Dx	Histology	Ref
Jungst et al., 2013	70	NA	Diabetes, variceal bleeding	NA	Cirrhosis on MRI, no focal lesion	7 yr	Ductal+lobular	[13]
Allison et al., 2004	42	ER-, PR-	Tobacco abuse, thrombocytopenia	Yes	Not performed	0 yr	Poorly differentiated	[9]
Allison et al., 2004	54	NA	Ascites, jaundice, hematochezia	Yes	Multiple masses on CT	9 yr	Poorly differentiated	[9]
Allison et al., 2004	36	NA	Nausea/vomiting/abd pain and jaundice	Yes	Small masses on CT	9 mo	Poorly differentiated	[9]
Hanamornroongruang and Sangchay, 2013	49	ER+, PR+	Weight loss, jaundice, abd pain	Yes	CT without mass	10 yr	Ductal, stage I	[2]
Martelli et al., 2000	53	ER+, PR+	Dyspnea, fever	NA	Hepatomegaly on US	4 yr	Ductal	[3]
Mogrovejo et al., 2014	67	ER+, PR-, HER2-	Fatigue, weakness, abdominal distention/jaundice, lower extremity edema	No	CT ascites	21 yr	Ductal+lobular	[4]
Borja et al., 1975	46	NA	Jaundice, ascites, spider angiomata	NA	CT cirrhosis	3 mo	Poorly differentiated	[5]
Graber et al., 2010	57	ER+, PR+, HER2+	Hyperthyroid, ascites, thrombocytopenia, hyperbilirubinemia	Yes	CT/US w/o mass, heterogeneous parenchyma	0 yr	Lobular	[6]
Fournier et al., 2010	52	ER+, PR-, HER2-	Bone mets from breast cancer, abdominal fullness	NA	CT with ascites, splenomegaly, but no liver abnormality	5 yr	Ductal, stage II	[10]
Goswami et al., 2011	38	ER-, PR+, HER2+	Malaise, lethargy, sore throat, dyspnea	NA	CT hepatomegaly, periportal nodes	0 yr	Ductal, grade 2	[11]
Morrison and Pennington, 1984	57	NA	Rapid fulminant hepatic failure	NA	NA	0 yr	Carcinoma NOS	[14]
Nakajima et al., 2005	68	NA	Drowsiness, disorientation, lymphangitic cancer spread to lungs	NA	CT normal liver, laparoscopic slight cirrhosis	8 mo	Ductal, stage I	[15]
Nascimento et al., 2001	62	NA	Ascites, edema	NA	US w/o mass, reversal of portal flow, MRI w cirrhosis	13 yr	NA	[16]
Nascimento et al., 2001	46	NA	Nausea, vomiting, abdominal girth increase, disseminated intravascular coagulopathy	NA	CT neg for lesions, MRI w cirrhosis	5 yr	Mucinous, poorly differentiated	[16]
Sass et al., 2007	55	ER+, PR-, HER2-	Jaundice, dark urine, acholic stool, and abdominal distension	NA	CT nodular contour c/w cirrhosis, no focal lesion	4 yr	Ductal, stage I	[17]
Shivashankar and Sweetser, 2012	66	ER+, PR+	Abdominal distention, hepatomegaly	NA	CT with cirrhosis, but no mass	8 yr	NA	[18]
Current case	69	ER+, PR+, HER2-	Bone mets from breast cancer, no presenting symptom, eventual leptomeningeal metastases	Yes	Cirrhosis on CT, US and MRI	9 yr	Ductal

NA: not available; E-cad: E-cadherin; ER: estrogen receptor; PR: progesterone receptor; Ref: reference number; NOS: not otherwise specified; CT: computerized tomography; MRI: magnetic resonance imaging.