Spontaneous rupture of hepatocellular carcinoma

Abstract

Spontaneous rupture of a primary hepatocellular carcinoma is an extremely rare event in the western hemisphere. Only a handful of single-case reports have been authored in the continental United States. A ruptured hepatoma carries a dismal prognosis and is usually beyond a "resection for cure" stage. In this report, two cases of spontaneously ruptured primary hepatocellular carcinoma are described. Both cases involved cirrhotic livers, and the tumor in each case was resected to attempt cure. One patient survived nearly 2 years; the other is alive and well at this time.

Spontaneous hepatic haemorrhage: a review of pathogenesis, aetiology and treatment

“…A spontaneous hepatic haemorrhage is a rare condition and was historically poorly recognized and infrequently diagnosed in patients presenting with shock. Less than 100 cases had been reported in the United States prior to 1980 . However, recent reports show that patients with SHH account for 1% of admissions to specialist liver units .…”

“…Less than 100 cases had been reported in the United States prior to 1980. 6 However, recent reports show that patients with SHH account for 1% of admissions to specialist liver units. 7,8 In areas of high prevalence of hepatocellular carcinoma (HCC), this tumour accounts for 15% of admissions with SHH and up to 10% of all HCC present with a spontaneous haemorrhage.…”

Hepatocellular Carcinoma (Ordinary Hepatocellular Carcinoma)

“…Rupture of HCC is a particularly severe (continued) complication of this neoplasm and bears a high mortality. Rupture may occur spontaneously or following blunt abdominal trauma (Ong and Taw 1972;Chearanai et al 1983;Van Landingham et al (1985); Clarkston et al (1988); Kanematsu et al (1992); Chen et al (1996); Castells et al (2001); Chedid et al 2001;Polat et al 2005;Lai and Lau 2006;Kim et al 2008). Spontaneous rupture of HCC can also occur in pediatric HCC (Nejmeddine et al 2010).…”

Spontaneous Hepatic Hemorrhage: An Unexpected Complication From Enoxaparin

“…Spontaneous hepatic hemorrhage (SHH) is a rare condition that occurs due to a breach in the liver parenchyma in the absence of an external cause [ 1 ]. The most common cause of SHH (10%) is hepatocellular carcinoma (HCC), followed by other causes such as benign liver lesions (hemangioma, adenoma, biliary cystadenoma), malignancies, amyloidosis, fatty liver of pregnancy, and connective tissue disorders such as lupus erythematosus [ 2 , 3 ]. SHH due to warfarin has been reported, however, isolated use of enoxaparin has not been linked with it [ 4 ].…”