Cutaneous Metastasis due to Breast Cancer in a Patient with Primary Biliary Cirrhosis: A Case Report

Background: Breast cancer is the most common solid tumor to cause cutaneous metastases. These are incurable and the treatment goal is geared toward local control with surgical excision, radiation, and chemotherapy. However, treatment can be challenging in subjects with end-stage liver disease and a multidisciplinary approach is warranted. Case Report: In this case report, we present a 61-year-old female with primary biliary cirrhosis and human epidermal growth factor-2 (HER-2)-positive breast cancer, who subsequently developed cutaneous metastases. We briefly describe the treatment challenges due to underlying end-stage liver disease, and an exceptional response to trastuzumab and nab-paclitaxel. Conclusion: A multidisciplinary approach to local control and attenuated doses of nab-paclitaxel and trastuzumab suggest a durable response to HER-2-positive breast cancer with cutaneous metastasis. Subjects with end-stage liver disease pose unique challenges and toxicities, warranting additional research and drug development for less hepatotoxic antineoplastic agents.

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Bone Marrow Mesenchymal Stem Cell treatment for end stage liver disease: A case report

Asian Journal of Surgery ◽

10.1016/j.asjsur.2019.11.019 ◽

2020 ◽

Vol 43 (2) ◽

pp. 454-455

Author(s):

Liang Yan ◽

Li Sha ◽

Yu Feng ◽

Jianping Huang

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Case Report ◽

Liver Disease ◽

Mesenchymal Stem Cell ◽

End Stage Liver Disease ◽

Stem Cell Treatment ◽

End Stage ◽

Mesenchymal Stem Cell Treatment

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Biliary Cyst (aka Choledochal Cyst): A Case Report of an Unusual Cause of End Stage Liver Disease in an 11-year old Female

The American Journal of Gastroenterology ◽

10.14309/00000434-200910003-00846 ◽

2009 ◽

Vol 104 ◽

pp. S311

Author(s):

Kara Sullivan ◽

Timothy Kinney ◽

Sarah Jane Schwarzenberg

Keyword(s):

Case Report ◽

Liver Disease ◽

Choledochal Cyst ◽

Biliary Cyst ◽

End Stage Liver Disease ◽

End Stage

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Liver Transplantation – A Case Report

Asian Journal of Nursing Education and Research ◽

10.52711/2349-2996.2021.00112 ◽

2021 ◽

pp. 466-472

Author(s):

Arockiaseeli Mabel Annarani. I ◽

Amalorpavamari Lucas ◽

Gnanadeepam Gnanadeepam ◽

Shirley Ann. C ◽

Christy Gunaseeli. S

Keyword(s):

Liver Transplantation ◽

Case Report ◽

Liver Disease ◽

Meld Score ◽

Blood Type ◽

End Stage Liver Disease ◽

Transplant Patients ◽

End Stage ◽

Active Alcohol ◽

Morbid Conditions

Liver transplantation is a treatment option for patients with End-stage Liver disease for whom all possible modes of surgical and medical treatment have been exhausted. The indications for Liver transplantation can be either acute or chronic liver disease. The absolute contra indications are active alcohol or substance abuse, severe cardiopulmonary or other co morbid conditions that would preclude meaningful recovery after transplant. Patients are listed on the waiting list according to their blood type and Model of End- Stage Liver Disease (MELD) score. The surgical procedure entails the excision of both donor and recipient livers and transplantation of the donor liver into the recipient (Orthotopic Liver Transplantation). This article gives an overview about liver transplantation and its management. A case report is presented and the nursing care has been discussed in detail.

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Paradoxical Emboli Secondary to Hepatic Pathology: Common or Coincidental?

Case Reports in Medicine ◽

10.1155/2009/184192 ◽

2009 ◽

Vol 2009 ◽

pp. 1-2 ◽

Cited By ~ 5

Author(s):

Patrik Gabikian ◽

Melanie Walker ◽

Abhineet M. Chowdhary ◽

Arthur M. Lam ◽

Gavin W. Britz

Keyword(s):

Case Report ◽

Liver Disease ◽

Clinical Examination ◽

Management Options ◽

End Stage Liver Disease ◽

Paradoxical Emboli ◽

Cirrhotic Patients ◽

End Stage ◽

Hepatic Pathology

Paradoxical cerebral emboli from cardiac and pulmonary sources are well described in the peer-reviewed literature. We outline a case with a hepatic etiology and describe diagnostic and management options. Though this paper represents the first documentation of such, we believe that transpulmonary shunting with concurrent paradoxical cerebral microemboli is more prevalent than recognized. We introduce this case report to compel practitioners to consider paradoxical emboli in selected cirrhotic patients since it can often be difficult to elicit subtle neurologic changes on clinical examination of patients with end stage liver disease.

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Case report: progressive familial intrahepatic cholestasis type 3 with compound heterozygous ABCB4 variants diagnosed 15 years after liver transplantation

BMC Medical Genetics ◽

10.1186/s12881-020-01173-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Mariam Goubran ◽

Ayodeji Aderibigbe ◽

Emmanuel Jacquemin ◽

Catherine Guettier ◽

Safwat Girgis ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Disease ◽

Intrahepatic Cholestasis ◽

Autoimmune Response ◽

Compound Heterozygous ◽

Biliary Cirrhosis ◽

Progressive Familial Intrahepatic Cholestasis ◽

End Stage Liver Disease ◽

End Stage ◽

Type 3

Abstract Background Progressive familial intrahepatic cholestasis (PFIC) type 3 is an autosomal recessive disorder arising from mutations in the ATP-binding cassette subfamily B member 4 (ABCB4) gene. This gene encodes multidrug resistance protein-3 (MDR3) that acts as a hepatocanalicular floppase that transports phosphatidylcholine from the inner to the outer canalicular membrane. In the absence of phosphatidylcholine, the detergent activity of bile salts is amplified and this leads to cholangiopathy, bile duct loss and biliary cirrhosis. Patients usually present in infancy or childhood and often progress to end-stage liver disease before adulthood. Case presentation We report a 32-year-old female who required cadaveric liver transplantation at the age of 17 for cryptogenic cirrhosis. When the patient developed chronic ductopenia in the allograft 15 years later, we hypothesized that the patient’s original disease was due to a deficiency of a biliary transport protein and the ductopenia could be explained by an autoimmune response to neoantigen that was not previously encountered by the immune system. We therefore performed genetic analyses and immunohistochemistry of the native liver, which led to a diagnosis of PFIC3. However, there was no evidence of humoral immune response to the MDR3 and therefore, we assumed that the ductopenia observed in the allograft was likely due to chronic rejection rather than autoimmune disease in the allograft. Conclusions Teenage patients referred for liver transplantation with cryptogenic liver disease should undergo work up for PFIC3. An accurate diagnosis of PFIC 3 is key for optimal management, therapeutic intervention, and avoidance of complications before the onset of end-stage liver disease.

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