Spontaneous ruptured of hepatocellular carcinoma in a young patient: A case report

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer-related deaths globally. Spontaneous rupture of HCC is a rare and acute complication with a high mortality rate, requiring urgent intervention. This report presents a rare case of spontaneous rupture of HCC in a 36-year-old female who presented to the emergency department of the General Hospital of Fortaleza with severe abdominal pain in the epigastric and right hypochondriac regions. A CT scan revealed a large, heterogeneous mass, mostly liquefied, with heterogeneous enhancement and poorly defined borders in segments II and III of the liver. The mass had an estimated volume of 1248 ml and had caused rupture of the hepatic cortex. Emergency exploratory surgery identified a large hemoperitoneum secondary to the spontaneous rupture of the liver tumor. Immunohistochemical analysis confirmed the diagnosis of hepatocellular carcinoma. Diagnosing rupture in patients without a history of cirrhosis or HCC can be challenging. We emphasize the need for radiologists to consider HCC rupture in the differential diagnosis of acute abdominal pain.