Spontaneous ruptured hepatocellular carcinoma

The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Spontaneous rupture of HCC occasionally occurs, and ruptured HCC with intraperitoneal hemorrhage is potentially life‐threatening. The most common symptom of ruptured HCC is acute abdominal pain. The tumor size in ruptured HCC is si...

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Bibliographic Details
Published in:Hepatology research 2016-01, Vol.46 (1), p.13-21
Main Authors: Yoshida, Hiroshi, Mamada, Yasuhiro, Taniai, Nobuhiko, Uchida, Eiji
Format: Article
Language:English
Subjects:
hepatectomy
hepatocellular carcinoma
rupture
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Summary:The incidence of hepatocellular carcinoma (HCC) is rising worldwide. Spontaneous rupture of HCC occasionally occurs, and ruptured HCC with intraperitoneal hemorrhage is potentially life‐threatening. The most common symptom of ruptured HCC is acute abdominal pain. The tumor size in ruptured HCC is significantly greater than that in non‐ruptured HCC, and HCC protrudes beyond the original liver margin. In the acute phase, hemostasis is the primary concern and tumor treatment is secondary. Transcatheter arterial embolization (TAE) can effectively induce hemostasis. The hemostatic success rate of TAE ranges 53–100%. A one‐stage surgical operation is a treatment modality for selected patients. Conservative treatment is usually given to patients in a moribund state with inoperable tumors and thus has poor outcomes. Patients with severe ruptures of advanced HCC and poor liver function have high mortality rates. Liver failure occurs in 12–42% of patients during the acute phase. In the stable phase, tumor treatment, such as transarterial chemoembolization or hepatic resection should be concerned. The combination of acute hemorrhage and cancer in patients with ruptured HCC requires a two‐step therapeutic approach. TAE followed by elective hepatectomy is considered an effective strategy for patients with ruptured HCC.
ISSN:1386-6346
1872-034X
DOI:10.1111/hepr.12498