Peliosis hepatis in cancer patients mimicking infection and metastases

• Published in: Onkologie Vol. 32; no. 1-2; p. 54
• Main Authors: Wannesson, Luciano, Chigrinova, Ekaterina, Raditchkova, Mariana, Mazzucchelli, Luca, Ghielmini, Michele
• Format: Journal Article
• Language: English
• Published: Switzerland 01.02.2009
• Subjects: Aged; Diagnosis, Differential; Female; Hepatitis - diagnosis; Humans; Leukemia, Myeloid, Acute - diagnosis; Liver Neoplasms - diagnosis; Liver Neoplasms - secondary; Middle Aged; Neuroendocrine Tumors - diagnosis; Peliosis Hepatis - diagnosis
• ISSN: 1423-0240
• DOI: 10.1159/000184579

Peliosis hepatis (PH) is a benign condition characterized by sinusoidal ectasia and blood-filled lacunar spaces within the liver parenchyma. The disease has been associated with a number of drugs and illnesses such as immunodeficiency states, infections, malignancy and other miscellaneous diseases. We describe the association of PH and cancer in two consecutive patients. In case 1, the peliotic lesions mimicked metastatic dissemination of a neuroendocrine tumor in a patient with normal octreoscan and tumor markers, parameters that were abnormal at the initial tumor diagnosis. In case 2, PH mimicked systemic candidiasis complicating the treatment of an acute myeloid leukemia, although in a clinical setting in which an infection was unlikely. Computed tomography (CT) imaging and a high level of clinical suspicion had a major role in the correct identification of this uncommon disorder, avoiding unnecessary antitumor-or anti-infection-oriented diagnostic procedures or therapies. PH should be considered in the differential diagnosis of new liver lesions in patients in whom the clinical settings do not clearly favor metastasization or infection. The detailed analysis of multiphase CT scan imaging is essential for a correct diagnosis. A liver biopsy should be performed to confirm this entity.