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We report the case of a 67 year old woman presenting with a mixed alteration of liver function tests. Despite normal results of tomodensitometry and positon emission tomography, a liver biopsy was performed due to the development of acute liver failure: it showed a diffuse infiltration of liver sinusoids by a breast adenocarcinoma, unfortunately fatal for the patient. The tumour infiltration was responsible for portal hypertension and hepatic perfusion disorders leading to liver failure.

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