Rupture of hepatocellular carcinoma: predictive value of CT findings.

Kanematsu, Masayuki; Imaeda, T; Yamawaki, Y; Seki, Matsuzo; Goto, Hironobu; Sone, Yoshitsugu; Iinuma, Gen; Mochizuki, Ryozo; Doi, Hidetaka

doi:10.2214/ajr.158.6.1317090

Cited by 62 publications

(40 citation statements)

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“…4,6,11,12,16,18,34 Ultrasonography (USG) and computed tomography of the abdomen are useful in demonstrating the presence of hemoperitoneum and liver tumor. 23,27,31,35 Computed tomography also has the advantage of showing the patency of the portal vein. However, the site of active bleeding can seldom be demonstrated.…”

Section: Diagnosismentioning

confidence: 99%

Spontaneous Rupture of Hepatocellular Carcinoma

Lai¹

2006

Arch Surg

213

270

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To review the management of spontaneous ruptured hepatocellular carcinoma in the acute phase, the definitive treatment after hemostasis, and the prognosis. Data Sources: A MEDLINE search was undertaken to identify articles in English from 1970 to 2004 using the key words "hepatocellular carcinoma," "spontaneous rupture," "therapeutic embolization," and "laparoscopy." Additional articles were identified by a manual search of the references from the key articles.Study Selection: There were no exclusion criteria for published information on the topics.Data Extraction: All studies that contained material applicable to the topic were considered.Data Synthesis: In the acute phase, transarterial embolization for hemostasis has a high success rate (53%-100%). It has a lower 30-day mortality rate than open surgical methods (0%-37% vs 28%-75%). For the definitive treatment, staged liver resection has a higher resection rate (21%-56% vs 13%-31%) and a lower in-hospital mortality rate (0%-9% vs 17%-100%) than 1-stage emergency liver resection. Staged liver resection has a good survival rate (1-year survival, 54.2%-100%; 3-year survival, 21.2%-48%; 5-year survival, 15%-21.2%).Conclusions: Transarterial embolization is effective in controlling bleeding from ruptured hepatocellular carcinoma in the acute phase. The serum bilirubin level, shock on hospital admission, and prerupture disease state are important prognostic factors to predict survival in the acute phase. For definitive treatment, staged liver resection after attaining hemostasis is better than 1-stage emergency liver resection. Laparoscopy and laparoscopic ultrasonography may decrease unnecessary exploratory laparotomy, thus increasing the resection rate of previously ruptured hepatocellular carcinoma. Prolonged survival can be achieved in select patients with definitive treatment. It is still uncertain whether the long-term outcome of liver resection is the same for hepatocellular carcinoma with and without rupture when patients with the same tumor stage and liver functional state are compared.

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Section: Diagnosismentioning

confidence: 99%

Spontaneous Rupture of Hepatocellular Carcinoma

Lai¹

2006

Arch Surg

213

270

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“…It is believed that a tear in the tumor surface or rupture of a feeding artery causes HCC rupture and is resulting in hemoperitoneum (10). The larger protruding tumors might tear more easily and are at the most risk of rupture.…”

Section: Resultsmentioning

confidence: 99%

“…HCCs often grow expansively, especially when tumors have an encompassing fibrous capsule (10).In such cases, intratumoral pressure may be elevated, thus predisposing rupture. Multiplanar reformation images using multi-detector row CT can provide improved confidence of contour protrusion of HCC with rupture.…”

Section: Resultsmentioning

confidence: 99%

Spontaneous Rupture of Hepatocellular Carcinoma and Hemoperitoneum-Management and Long Term Survival

Veltchev¹

2010

JofIMAB

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Aims:Complications of HCC as spontaneous rupture and hemoperitoneum are life threatening and have been observed particularly in patients with superficially dislodged tumors with associated cirrhosis.Methods: Retrospective analysis of patients from hepatobiliary and liver transplantation units. Three cases for the past 15 years were found.Results: Of all three patients with ruptured HCC, one was operated in emergency because of positive abdominal punction for hemoperitoneum and active bleeding. In the other two patients, after emergency diagnostic US, CT and angiographic study, it was decided to perform selective embolization to stop bleeding and stabilize hemodynamic and in second stage proposed liver resection. The age of the patients at time of first accident was 36, 58 and 75, respectively two men and a woman. All patients were diagnosed with associated liver disease-cirrhosis.Diagnostic procedures and pathologic specimens showed superficially localization of ruptured tumoral nodules: predominantly in right liver lobe. The number of lesion was between 1 and 3, and in later stage, after progressing of the cancer process, it was diagnosed multiple.The mean size of tumor nodule was 3.0 cm. Three times repeated rupture was treated none surgically by chemoembolization.The 3, 5 and 10 year survival was 100%.

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“…Previous reports have indicated that tumors with larger sizes and greater extrahepatic protrusion rupture more frequently (6).…”

Section: Case Reportmentioning

confidence: 94%

Hemothorax Caused by Spontaneous Rupture of Hepatocellular Carcinoma in the Pleural Cavity: A Case Report

Seo

Ohm

Kim

et al. 2017

J Korean Soc Radiol

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Rupture of hepatocellular carcinoma: predictive value of CT findings.

Cited by 62 publications

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Spontaneous Rupture of Hepatocellular Carcinoma

Spontaneous Rupture of Hepatocellular Carcinoma

Spontaneous Rupture of Hepatocellular Carcinoma and Hemoperitoneum-Management and Long Term Survival

Hemothorax Caused by Spontaneous Rupture of Hepatocellular Carcinoma in the Pleural Cavity: A Case Report

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Rupture of hepatocellular carcinoma: predictive value of CT findings.

Cited by 62 publications

References 0 publications

Spontaneous Rupture of Hepatocellular Carcinoma

Spontaneous Rupture of Hepatocellular Carcinoma

Spontaneous Rupture of Hepato­cellu­lar Carcinoma and Hemo­peritoneum-Management and Long Term Survival

Hemothorax Caused by Spontaneous Rupture of Hepatocellular Carcinoma in the Pleural Cavity: A Case Report

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Spontaneous Rupture of Hepatocellular Carcinoma and Hemoperitoneum-Management and Long Term Survival