Acute Abdomen: A Rare Case of Ruptured Hepatocellular Carcinoma

TLDR

Spontaneous rupture of hepatocellular carcinoma is uncommon but poses urgent therapeutic choices, with options ranging from conservative management to transarterial embolization or surgery, and selection depends on factors such as viral status, Child‑Pugh grade, cirrhosis, tumor burden, and requires interdisciplinary coordination. In this case, transarterial embolization was chosen as bridging therapy to reduce perioperative morbidity and mortality before further diagnostics and definitive treatment.

Abstract

Spontaneous ruptures of hepatocellular carcinoma (HCC) are rare. Nevertheless they may lead to difficult decisions in the emergency situation. The acute therapies include conservative treatment, transarterial embolization and surgery. Curative treatment of HCC can be achieved by liver resection solely. The decision-making depends on prognostic patient’s factors, such as hepatic viral infection status, Child-Pugh grade, liver cirrhosis and number of tumors. In this case transarterial embolization was preferable as a bridging therapy prior to further diagnostics and therapy, to lower the perioperative morbidity and mortality. The therapy of these cases needs an interdisciplinary approach to choose the best possible procedure in each case.