• Hyeli Park and Sun Young Lee.
• Department of Radiation Oncology, Presbyterian Medical Center, Jeonju, Jeonbuk, Republic of Korea.
• Medicine (Baltimore). 2024 Aug 23; 103 (34): e39191e39191.

RationaleRadiation-induced liver disease (RILD) is an established complication of hepatic irradiation that is typically reported in patients receiving high-dose radiotherapy for hepatocellular carcinoma or liver metastases. However, RILD can also occur after unintentional low-dose liver exposure during radiotherapy for other gastrointestinal malignancies when careful precautions are not taken.Patient ConcernsWe report the case of a 44-year-old woman with gastric mucosa-associated lymphoid tissue lymphoma who underwent salvage radiotherapy administered to the entire stomach. One month after completing this radiotherapy, computed tomography and magnetic resonance imaging of the patient's abdomen revealed a 4 cm lesion in the left lateral liver segment, suggestive of metastasis.DiagnosesAn ultrasound-guided biopsy was performed, and the histopathological findings were consistent with those of RILD.InterventionsConservative management was pursued with close monitoring of liver function tests.OutcomesThe patient's imaging findings and liver enzyme levels normalized approximately 3 months after the initial diagnosis.LessonsThis case highlights the importance of considering RILD in the differential diagnosis of new hepatic lesions detected after radiotherapy, even in patients with low-dose liver exposure within generally acceptable limits. Careful correlation with the radiotherapy plan is crucial to avoid misdiagnosing RILD as metastatic disease and to guide appropriate management.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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