Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome
Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history wa...
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doaj-04e39aa84aab4b5ab9606f5f7871f9652020-11-25T00:00:38ZengKarger PublishersCase Reports in Gastroenterology1662-06312018-01-01121192610.1159/000486193486193Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal OutcomeDavid F. Pinal-GarcíaCarlos M. Nuño-GuzmánAudrey Gómez-AbarcaJorge L. CoronaIsmael EspejoSpontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography. Two actively bleeding liver tumors and multiple tumors in a noncirrhotic liver were found. Hemostatic suture and perihepatic packing were performed. The patient remained in critical condition, with a fatal outcome 48 h later. Histopathologic analysis reported HCC and absence of cirrhotic changes. HCC spontaneous rupture incidence is reported between 2.3 and 26%. Median age is 65 years. No liver cirrhosis is found in one-third of patients, with a median age of 51 years. Sudden onset of abdominal pain and shock is observed in the majority of cases. An accurate preoperative diagnosis improves to 75% with ultrasound and computed tomography. Besides hemodynamic stabilization, there is no general agreement on the best treatment option. Transarterial embolization, surgical perihepatic packing, suture plication, and hepatic artery ligation are useful methods of hemostasis in unstable patients. Mortality has been reported from 16.5 to 100%. The histopathologic finding of HCC in a noncirrhotic liver represents a less frequent presentation. A case of spontaneous rupture of HCC carcinoma and a noncirrhotic liver in a young patient is herein reported.https://www.karger.com/Article/FullText/486193Bleeding hepatocellular carcinomaRuptured hepatocellular carcinomaSpontaneous liver ruptureCase report |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
David F. Pinal-García Carlos M. Nuño-Guzmán Audrey Gómez-Abarca Jorge L. Corona Ismael Espejo |
spellingShingle |
David F. Pinal-García Carlos M. Nuño-Guzmán Audrey Gómez-Abarca Jorge L. Corona Ismael Espejo Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome Case Reports in Gastroenterology Bleeding hepatocellular carcinoma Ruptured hepatocellular carcinoma Spontaneous liver rupture Case report |
author_facet |
David F. Pinal-García Carlos M. Nuño-Guzmán Audrey Gómez-Abarca Jorge L. Corona Ismael Espejo |
author_sort |
David F. Pinal-García |
title |
Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome |
title_short |
Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome |
title_full |
Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome |
title_fullStr |
Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome |
title_full_unstemmed |
Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome |
title_sort |
spontaneous rupture of hepatocellular carcinoma in a young patient with fatal outcome |
publisher |
Karger Publishers |
series |
Case Reports in Gastroenterology |
issn |
1662-0631 |
publishDate |
2018-01-01 |
description |
Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography. Two actively bleeding liver tumors and multiple tumors in a noncirrhotic liver were found. Hemostatic suture and perihepatic packing were performed. The patient remained in critical condition, with a fatal outcome 48 h later. Histopathologic analysis reported HCC and absence of cirrhotic changes. HCC spontaneous rupture incidence is reported between 2.3 and 26%. Median age is 65 years. No liver cirrhosis is found in one-third of patients, with a median age of 51 years. Sudden onset of abdominal pain and shock is observed in the majority of cases. An accurate preoperative diagnosis improves to 75% with ultrasound and computed tomography. Besides hemodynamic stabilization, there is no general agreement on the best treatment option. Transarterial embolization, surgical perihepatic packing, suture plication, and hepatic artery ligation are useful methods of hemostasis in unstable patients. Mortality has been reported from 16.5 to 100%. The histopathologic finding of HCC in a noncirrhotic liver represents a less frequent presentation. A case of spontaneous rupture of HCC carcinoma and a noncirrhotic liver in a young patient is herein reported. |
topic |
Bleeding hepatocellular carcinoma Ruptured hepatocellular carcinoma Spontaneous liver rupture Case report |
url |
https://www.karger.com/Article/FullText/486193 |
work_keys_str_mv |
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