Hepatocellular carcinoma is the sixth most common neoplasm in the world and the third cause of death in cancer patients. Mortality in patients with this condition is mainly due to cancer cachexia, liver failure, and spontaneous tumor rupture. This report describes the clinical case of a 69-year-old patient who attended the hospital emergency department complaining of sudden onset abdominal pain located in the epigastrium and vomiting with a tendency to hypotension. The patient had to undergo emergency surgery due to the rupture of a previously unknown hepatocellular carcinoma. In addition to the clinical description of the case, the study is accompanied by a discussion on the possibilities of therapeutic management of this type of patient based on the international literature on the subject.

El carcinoma hepatocelular es la sexta neoplasia más frecuente en el mundo y la tercera causa de muerte en pacientes oncológicos. La mortalidad en los pacientes con esta condición se debe fundamentalmente a la caquexia tumoral, la insuficiencia hepática y la rotura espontánea del tumor. En este reporte se describe el caso clínico de un paciente de 69 años que acudió al servicio de urgencias hospitalarias aquejado de dolor abdominal de inicio súbito localizado en el epigastrio y vómitos con tendencia a la hipotensión, el cual tuvo que ser intervenido de