Pseudocirrhosis in Metastatic Breast Cancer in a Male Successfully Treated with Leuprorelin and Anastrozole Followed by Eribulin: A Case Report

Introduction: There are very few studies and cases in the literature describing metastatic breast cancer in the male population, accounting for less than one percent of all cases. Of those who have been reported, the vast majority fail to survive beyond five years from time of diagnosis. The lack of literature in this population makes it difficult for clinicians to foresee and prepare for upcoming complications in management. One of the more serious complications in managing metastatic breast cancer is the development of pseudocirrhosis, a frequent long-term side effect of chemotherapy and/or radiation typically seen in patients with malignancy in the liver.

Case Presentation: We report the case of a 48-year-old male with a completely unremarkable family, medical, and social history other than a homozygous mutation in his MTHFR gene who was diagnosed with stage IV ER/PR-positive, HER-2/neu negative, BRCA1 and BRCA2-negative breast cancer with metastasis to bone, lung, and liver. He was successfully treated with an initial regimen consisting of radiation, Denosumab, Leuprorelin, and Anastrozole. After completing five years of hormone therapy, he was initiated on Eribulin. Eight years since time of diagnosis, he continues to survive and undergo symptomatic management of long-term side-effects of his treatments.

Conclusions: To our knowledge this is the only reported case of metastatic breast cancer with pseudocirrhosis in a male patient. It is imperative to report this unique case to help increase awareness for clinicians managing other males with breast cancer. What makes this case even more reportable is the good outcome overall as our patient remains alive and well eight years since time of diagnosis, a relatively difficult and rare feat to achieve in end-stage breast cancer.