Marked Enlargement of Liver Over a Short Period of Time

Takeshi Saraya, MD, PhD

Assistant Professor, Department of Respiratory Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka City, Tokyo 181-8611, Japan; Tel. +81 (0)422 44 0671; Fax: +81 (0)422 44 0671; E-mail: sara@yd5.so-net.ne.jp

An 81-year-old man with Small cell lung cancer (limited type), who had been treated with various intravenous chemotherapies combined with irradiation during the previous year, was admitted to our hospital (day 1) for his third intravenous chemotherapy dose. Contrast-enhanced thoraco-abdominal computed tomography on day 1 demonstrated that the primary lung cancer had not grown (data not shown); however, multiple new metastatic tumors in the liver, up to 5 mm in diameter, were seen (Figure A). Two weeks later, the liver was markedly enlarged (Figure B) and repeated Computed tomography (CT). It demonstrated rapidly progressing; various sized multiple ring-enhanced tumors along with evidence of tumor lysis syndrome. On day 23, he died of multiple organ failure. Liver metastasis is a common occurrence in lung cancer patients, but the rapid enlargement of the liver over such a short time period is an extremely rare phenomenon.¹

1. Sato K, Takeyama Y, Tanaka T, Fukui Y, Gonda H, Suzuki R. Fulminant hepatic failure and hepatomegaly caused by diffuse liver metastases from small cell lung carcinoma: 2 autopsy cases. Respir Investig. 2013; 51(2): 98-102. doi: 10.1016/j.resinv.2012.12.004