J Korean Med Sci.  2004 Dec;19(6):895-897. 10.3346/jkms.2004.19.6.895.

Spontaneous Intratumoral Hemorrhage into Hepatocellular Carcinoma During Transcatheter Arterial Embolization: A Case Report

• Choi JH
• Kim JH
• Won JH
• Kim YS
• Goo DE
• Choi DL

• KMID: 1778576
• DOI: http://doi.org/10.3346/jkms.2004.19.6.895

Abstract

Spontaneous extrahepatic rupture of hepatocellular carcinoma (HCC) is a rare but serious complication that occurs with an incidence of between 5 and 15% of patients with HCC. It is thought to be preceded by rapid expansion due to intratumoral bleed-ing. Extrahepatic rupture of HCC has been reported as a rare complication of tran-scatheter arterial embolization (TAE). Although there have been reports of extrahepatic rupture of HCC after TAE, but there is no report regarding intratumoral hemor-rhage into HCC during TAE. We report a unique case of intratumoral hemorrhage into HCC during TAE presumably triggered by TAE. Although a rare complication, intratumoral hemorrhage into HCC after TAE should be considered in any patient with TAE due to HCC.

Keyword

Chemoembolization, Therapeutic; Carcinoma, Hepatocellular; Liver Neoplasms

MeSH Terms

Carcinoma, Hepatocellular/*blood supply
Catheterization/*adverse effects
Embolization, Therapeutic/*adverse effects
Hemorrhage/*diagnosis/*etiology
Humans
Liver Neoplasms/*blood supply
Male
Middle Aged
Rupture, Spontaneous/diagnosis/etiology

Figure

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  Fig. 1 Contrast-enhanced CT scanning in the arterial phase shows two well-demarcated masses in both lobes of the liver. A mass in the right lobe shows the enhancement on the arterial phase with central low density. A mass in the left lobe shows homogeneous enhancement.

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  Fig. 2 Heptic angiography shows tortuous vessels with staining of masses in both lobes of the liver.

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  Fig. 3 Serial hepatic angiography after embolization of the right hepatic artery shows intratumoral gush of contrast material in the left lobe.

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