J Korean Soc Radiol.  2012 Aug;67(2):109-112. 10.3348/jksr.2012.67.2.109.

Rupture of Hepatocellular Carcinoma Following Transcatheter Arterial Chemoembolization: A Case Report

Affiliations
  • 1Department of Radiology, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea. bhlee@paik.ac.kr
  • 2Department of Radiology, Seonam Hospital, Ewha Womans University School of Medicine, Seoul, Korea.

Abstract

Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment for unresectable hepatocellular carcinoma (HCC). Serious complications, such as neutropenic sepsis and hepatic decompensation, are well known. A HCC rupture following TACE is a rare complication; however, it can be life-threatening if it occurs. In a 75-year-old male patient who subsequently developed capsular rupture of the lipiodol laden mass and several free intraperitoneal chemoembolization agents with hemoperitoneum, we report a case of a ruptured HCC that superficially located arterial enhancing and early wash-out mass in the right hepatic dome following TACE.


MeSH Terms

Aged
Carcinoma, Hepatocellular
Ethiodized Oil
Hemoperitoneum
Humans
Male
Palliative Care
Rupture
Sepsis
Ethiodized Oil

Figure

  • Fig. 1 A 75-year-old male who was incidentally diagnosed with HCC. A. Arterial phase axial contrast enhanced CT scan of the upper abdomen shows a superficially located, enhanced tumor (arrow) in segment VIII before hepatic chemoembolization. B. Venous phase coronal CT scan reveals early wash-out of the mass (arrow). C. Angiography of the celiac trunk before chemoembolization indicated a hypervascular hepatic mass (arrow) with numerous feeding vessels in the right hepatic dome. D. Hepatic angiography after chemoembolization revealed complete devascularization in the lesion (arrow). E, F. Axial contrast enhanced CT scan obtained one day after TACE shows a capsular rupture at the level of the lipiodol laden lesion (arrow) and several free intraperitoneal chemoembolization agents with hemoperitoneum (open arrows). Note.-HCC = hepatocellular carcinoma, TACE = transcatheter arterial chemoembolization


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