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Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312-773X (Online)
Issue: Volume 15, book 1, 2009
Subject Collection: Medicine
Page: 53 - 57
DOI: 10.5272/jimab.1512009_53
Online date: Aug 7, 2009,
SPONTANEOUS RUPTURE OF HEPATOCELLULAR CARCINOMA
AND HEMOPERITONEUM-MANAGEMENT AND LONG TERM SURVIVAL
Ludmil
M. Veltchev
Fellow, Department of Surgical Oncology, The University of Texas M.
D. Anderson Cancer Center,Houston, USA
ABSTRACT: Aims: Complications
of HCC as spontaneous rupture and hemoperitoneum are life threatening
and have been observed particularly in patients with superficially dislodged
tumors with associated cirrhosis.
Methods: Retrospective analysis of patients from hepatobiliary
and liver transplantation units. Three cases for the past 15 years were
found.
Results: Of all three patients with ruptured HCC, one
was operated in emergency because of positive abdominal punction for hemoperitoneum
and active bleeding. In the other two patients, after emergency diagnostic
US, CT and angiographic study, it was decided to perform selective embolization
to stop bleeding and stabilize hemodynamic and in second stage proposed
liver resection. The age of the patients at time of first accident was
36, 58 and 75, respectively two men and a woman. All patients were diagnosed
with associated liver disease-cirrhosis.
Diagnostic procedures and pathologic specimens showed superficially localization
of ruptured tumoral nodules: predominantly in right liver lobe. The number
of lesion was between 1 and 3, and in later stage, after progressing of
the cancer process, it was diagnosed multiple.
The mean size of tumor nodule was 3.0 cm. Three times repeated rupture
was treated none surgically by chemoembolization.
The 3, 5 and 10 year survival was 100%. .
Key words: hepatocellular carcinoma; spontaneous rupture;
long-term management.
Page: 53-57; FULL TEXT PDF (216 KB)