J Liver Cancer.  2019 Mar;19(1):59-63. 10.17998/jlc.19.1.59.

A Case of Spontaneous Rupture of Hepatocellular Carcinoma Supplied by the Right Renal Capsular Artery Treated by Transcatheter Arterial Embolization

  • 1Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Busan, Korea. junwb73@pnuyh.co.kr
  • 2Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Busan, Korea.


We present a case of spontaneous rupture of hepatocellular carcinoma with poor liver function managed by transcatheter arterial embolization (TAE). The patient's bilirubin level was 2.1 mg/dL, albumin level was 2.4 g/dL, and prothrombin time international normalized ratio was 2.1. In addition, the patient had also developed a large number of ascites. The tumor was supplied by the right renal capsular artery, as observed on angiography. With successful TAE, no hepatic failure occurred. We believe TAE can be a safe and effective treatment option, even in patients with poor liver function, if tumors are supplied only by extrahepatic collateral vessels.


Hepatocellular carcinoma; Spontaneous rupture; Renal capsular artery; Extrahepatic collateral; Transcatheter arterial embolization

MeSH Terms

Carcinoma, Hepatocellular*
International Normalized Ratio
Liver Failure
Prothrombin Time
Rupture, Spontaneous*


  • Figure 1. Abdomen computed tomography (CT) findings. (A) CT shows infiltrating hypodense mass (arrow) at the posterior inferior segment (segment 6) of right hepatic lobe with large amount of ascites and hematoma (arrowhead). (B) Arterial phase CT demonstrates extravasation (arrow) of contrast media from this mass and hemoperitoneum.

  • Figure 2. Transcatheter arterial embolization. (A) Celiac arteriography demonstrates the tumor stain in the right lobe of the liver without evidence of extravasation. (B) Right renal arteriography depicts contrast extravasation (arrow) from right renal capsular artery (arrowhead). (C) Selective arteriography through the right renal capsular artery reveals a tumor stain (arrowhead) and extravasation (arrow). (D) After embolization, the tumor stain and extravasation disappeared.


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