Hepar lobatum carcinomatosum due to metastatic breast carcinoma.

This is the first clinico-pathological report of hepar lobatum carcinomatosum (HLC), the rarest form of metastatic liver disease. The primary lesion was a scirrhous breast carcinoma. HLC closely resembles its syphilitic counterpart macroscopically, and is characterized by multifocal cancer-bearing scars and compensatory hyperplasia of the spared liver parenchyma. Multifocal carcinomatous obstruction of portal and hepatic venous vessels as well as rather slow progression of the clinical course may determine the development of HLC. In addition to the possible association of portal hypertension, the differential diagnosis from other types of unusual liver metastasis is discussed.