Acute liver failure (ALF) requires early and very precise treatment decisions for a diagnosis that is not often easy and may lead to erroneous decisions. Accordingly, we undertook a review of ALF secondary to malignant infiltration given the rarity of the condition, plus its singularity and therapeutic implications. This review should aid in establishing future frameworks for action. Analyze cases of ALF secondary to malignant infiltration in our center during the last 5 years and review the literature. We undertook a retrospective review of all cases of ALF due to malignant infiltration in our center between January 2015 and December 2019. Data were recorded on demographic characteristics, clinical presentation, type of tumor, diagnostic techniques used, treatment and evolution. We also undertook a literature review on the subject and compared the results. AFL secondary to malignant infiltration was diagnosed in five patients, four women and one man with a median age 58 years. The most common clinical presentation was jaundice. Three cases were due to infiltration by hematological tumors (non-Hodgkin lymphoma and histiocytosis), one a cholangiocarcinoma and one lung cancer. In all cases a liver biopsy was required for diagnosis, this being conclusive in four cases; diagnosis in the non-conclusive case was by analysis of the hepatectomy sample after transplantation. Three patients died due to AFL in a mean of 13.8 days, another died 5 months after diagnosis as a consequence of the tumor while the patient with a diagnosis of non-Hodgkin lymphoma and transplant recipient remains alive after a follow-up of 6 years and after receiving chemotherapy. AFL due to malignant infiltration is a very unusual condition but with a high rate of mortality. It requires a rapid and precise diagnosis given the relevant treatment options.

急性肝衰竭 (ALF) 需要及早做出非常精确的治疗决策，但诊断往往并不容易，并且可能会导致错误的决策。因此，考虑到继发于恶性浸润的 ALF 的罕见性及其独特性和治疗意义，我们对继发性 ALF 进行了回顾。此次审查应有助于建立未来的行动框架。分析我中心近5年来继发恶性浸润的ALF病例并复习文献。我们对 2015 年 1 月至 2019 年 12 月期间本中心因恶性浸润导致的所有 ALF 病例进行了回顾性分析。记录了人口特征、临床表现、肿瘤类型、使用的诊断技术、治疗和演变的数据。我们还对该主题进行了文献综述并比较了结果。继发于恶性浸润的 AFL 被诊断为 5 名患者，其中 4 名女性和 1 名男性，中位年龄 58 岁。最常见的临床表现是黄疸。3例因血液肿瘤（非霍奇金淋巴瘤和组织细胞增多症）浸润，1例为胆管癌，1例为肺癌。所有病例都需要进行肝活检才能诊断，其中有四例是结论性的；非结论性病例的诊断是通过分析移植后的肝切除样本进行的。三名患者平均在 13.8 天内因 AFL 死亡，另一名患者在诊断后 5 个月因肿瘤死亡，而诊断为非霍奇金淋巴瘤且接受移植的患者在随访 6 年后仍然存活，接受化疗后。恶性浸润引起的 AFL 是一种非常罕见的疾病，但死亡率很高。它需要根据相关的治疗方案进行快速、准确的诊断。