[Unexpected diagnosis of thorotrast-induced cirrhosis]

Abstract

It is presented the clinical case of a 73 year old man admitted to hospital with dyspnea and productive cough. Clinico-instrumental investigations demonstrated monolateral pleural effusion and ascites in a severe cirrhotic chronic liver failure. After evacuation of the pleural and peritoneal effusion, chest radiography showed the presence of a double accumulation of radiopaque material in left cervical region and in left paramediastinic site. Chest and abdominal CT scan showed a systemic accumulation of this material in liver, spleen and glands. The characteristics of the iperreflecting substance accumulated were compatible with that of Thorotrast. In the mean time, a prostate cancer with skeletal metastases was diagnosed. Despite therapy, the chronic liver failure causes a rapid deterioration of clinical conditions, with irreversible hepatic coma and death.