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Occult Malignancy Presenting as Acute Fulminant Hepatic Failure

Only six cases of hepatic metastatic disease presenting as acute fulminant liver failure have been recorded in the literature. A seventh case is reported here where, after presenting in acute liver failure, it was not possible to establish a tissue diagnosis but evidence of massive liver replacement by tumour was provided by ultrasound imaging and radionuclide scintiscanning.