Extensive hepatic metastases from combined Epstein-Barr virus infection with acute hepatic failure in small cell lung cancer: A case report.

RATIONALE: The management of small cell lung cancer patients with acute hepatic failure presents significant challenges due to contraindications for standard chemotherapeutic agents.

PATIENT CONCERNS: A 72-year-old male with a history of colorectal cancer (postoperative status) was admitted to our hospital with malaise, nausea, and jaundice. During hospitalization, he exhibited persistently elevated and rapidly rising alanine aminotransferase and bilirubin levels, accompanied by clinical deterioration.

DIAGNOSES: Primary small cell lung cancer with extensive hepatic metastases and hyperbilirubinemia was diagnosed, along with concurrent Epstein-Barr virus infection, confirmed through postoperative histopathological examination and ancillary diagnostic studies.

INTERVENTIONS AND OUTCOMES: Following diagnosis, the patient underwent chemotherapy. Posttreatment laboratory monitoring demonstrated a progressive decline in both serum bilirubin levels and hepatic enzyme indices.

LESSONS: Exploring a balance between life-saving salvage therapy and respecting these contraindications is critical in optimizing outcomes for such high-risk oncology patients.