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Semin intervent Radiol 2015; 32(01): 049-053
DOI: 10.1055/s-0034-1396964
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hepatocellular Carcinoma Rupture Following Transarterial Chemoembolization

Nimarta Singh Bhinder
1   Department of Radiology, Section of Interventional Radiology, University of Chicago, Chicago, Illinois
,
Steven M. Zangan
1   Department of Radiology, Section of Interventional Radiology, University of Chicago, Chicago, Illinois
› Author Affiliations
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Publication History

Publication Date:
02 March 2015 (online)

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Abstract

As the incidence of primary and metastatic liver cancer increases, minimally invasive treatment methods such as transarterial chemoembolization (TACE) have gained momentum as their efficacy and safety profile have been validated. Complications of TACE are rare and typically well tolerated. A unique complication is tumor rupture with hemorrhage. Reports of hepatocellular carcinoma (HCC) rupture after TACE are limited. It is critical to recognize this complication and understand the treatment options, which range from conservative to surgical management. This report describes a case of HCC rupture following TACE successfully managed with coil embolization.

Keywords

hepatocellular carcinoma - transarterial chemoembolization - spontaneous rupture - intraperitoneal hemorrhage - interventional radiology
 

  • References

  • 1 Clark TW. Complications of hepatic chemoembolization. Semin Intervent Radiol 2006; 23 (2) 119-125
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Brown DB, Nikolic B, Covey AM , et al; Society of Interventional Radiology Standards of Practice Committee. Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol 2012; 23 (3) 287-294
    CrossrefPubMedSearch in Google Scholar
  • 3 Kasotakis G. Spontaneous hemoperitoneum. Surg Clin North Am 2014; 94 (1) 65-69
    CrossrefPubMedSearch in Google Scholar
  • 4 Lucey BC, Varghese JC, Anderson SW, Soto JA. Spontaneous hemoperitoneum: a bloody mess. Emerg Radiol 2007; 14 (2) 65-75
    CrossrefPubMedSearch in Google Scholar
  • 5 Lucey BC, Varghese JC, Soto JA. Spontaneous hemoperitoneum: causes and significance. Curr Probl Diagn Radiol 2005; 34 (5) 182-195
    CrossrefPubMedSearch in Google Scholar
  • 6 Zhu LX, Geng XP, Fan SD. Mechanism of spontaneous rupture of hepatocellular carcinoma [in Chinese]. Zhonghua Wai Ke Za Zhi 2004; 42 (17) 1036-1039
    PubMedSearch in Google Scholar
  • 7 Zhu LX, Meng XL, Fan ST. Elasticity of small artery in patient with spontaneous rupture of hepatocellular carcinoma. Hepatol Res 2004; 29 (1) 13-17
    CrossrefPubMedSearch in Google Scholar
  • 8 Zhu LX, Liu Y, Fan ST. Ultrastructural study of the vascular endothelium of patients with spontaneous rupture of hepatocellular carcinoma. Asian J Surg 2002; 25 (2) 157-162
    CrossrefPubMedSearch in Google Scholar
  • 9 Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury. Arch Surg 2001; 136 (6) 682-687
    CrossrefPubMedSearch in Google Scholar
  • 10 Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma. Br J Surg 1996; 83 (5) 602-607
    CrossrefPubMedSearch in Google Scholar
  • 11 Li J, Huang L, Liu CF , et al. Risk factors and surgical outcomes for spontaneous rupture of BCLC stages A and B hepatocellular carcinoma: a case-control study. World J Gastroenterol 2014; 20 (27) 9121-9127
    PubMedSearch in Google Scholar
  • 12 Al-Mashat FM, Sibiany AM, Kashgari RH , et al. Spontaneous rupture of hepatocellular carcinoma. Saudi Med J 2002; 23 (7) 866-870
    PubMedSearch in Google Scholar
  • 13 Kim HC, Yang DM, Jin W, Park SJ. The various manifestations of ruptured hepatocellular carcinoma: CT imaging findings. Abdom Imaging 2008; 33 (6) 633-642
    CrossrefPubMedSearch in Google Scholar
  • 14 Liu CL, Fan ST, Lo CM , et al. Management of spontaneous rupture of hepatocellular carcinoma: single-center experience. J Clin Oncol 2001; 19 (17) 3725-3732
    PubMedSearch in Google Scholar
  • 15 Miyoshi A, Kitahara K, Kohya N, Noshiro H, Miyazahi K. Outcomes of patients with spontaneous rupture of hepatocellular carcinoma. Hepatogastroenterology 2011; 58 (105) 99-102
    PubMedSearch in Google Scholar
  • 16 Tan FL, Tan YM, Chung AY, Cheow PC, Chow PK, Ooi LL. Factors affecting early mortality in spontaneous rupture of hepatocellular carcinoma. ANZ J Surg 2006; 76 (6) 448-452
    CrossrefPubMedSearch in Google Scholar
  • 17 Jia Z, Tian F, Jiang G. Ruptured hepatic carcinoma after transcatheter arterial chemoembolization. Curr Ther Res Clin Exp 2013; 74: 41-43
    CrossrefPubMedSearch in Google Scholar
  • 18 Battula N, Srinivasan P, Madanur M , et al. Ruptured hepatocellular carcinoma following chemoembolization: a western experience. Hepatobiliary Pancreat Dis Int 2007; 6 (1) 49-51
    PubMedSearch in Google Scholar
  • 19 Reso A, Ball CG, Sutherland FR, Bathe O, Dixon E. Rupture and intra-peritoneal bleeding of a hepatocellular carcinoma after a transarterial chemoembolization procedure: a case report. Cases J 2009; 2 (1) 68
    CrossrefPubMedSearch in Google Scholar
  • 20 Shin BS, Park MH, Jeon GS. Outcome and prognostic factors of spontaneous ruptured hepatocellular carcinoma treated with transarterial embolization. Acta Radiol 2011; 52 (3) 331-335
    CrossrefPubMedSearch in Google Scholar
  • 21 Buczkowski AK, Kim PT, Ho SG , et al. Multidisciplinary management of ruptured hepatocellular carcinoma. J Gastrointest Surg 2006; 10 (3) 379-386
    CrossrefPubMedSearch in Google Scholar
  • 22 Chen CY, Lin XZ, Shin JS , et al. Spontaneous rupture of hepatocellular carcinoma. A review of 141 Taiwanese cases and comparison with nonrupture cases. J Clin Gastroenterol 1995; 21 (3) 238-242
    CrossrefPubMedSearch in Google Scholar
  • 23 Hai L, Yong-Hong P, Yong F, Ren-Feng L. One-stage liver resection for spontaneous rupture of hepatocellular carcinoma. World J Surg 2005; 29 (10) 1316-1318
    CrossrefPubMedSearch in Google Scholar
  • 24 Rossetto A, Adani GL, Risaliti A , et al. Combined approach for spontaneous rupture of hepatocellular carcinoma. World J Hepatol 2010; 2 (1) 49-51
    PubMedSearch in Google Scholar
  • 25 Tarantino L, Sordelli I, Calise F, Ripa C, Perrotta M, Sperlongano P. Prognosis of patients with spontaneous rupture of hepatocellular carcinoma in cirrhosis. Updates Surg 2011; 63 (1) 25-30
    CrossrefPubMedSearch in Google Scholar
  • 26 Yoshida H, Mamada Y, Taniai N , et al. Long-term results of elective hepatectomy for the treatment of ruptured hepatocellular carcinoma. J Hepatobiliary Pancreat Surg 2008; 15 (2) 178-182
    CrossrefPubMedSearch in Google Scholar
  • 27 Darnis B, Rode A, Mohkam K, Ducerf C, Mabrut JY. Management of bleeding liver tumors. J Vis Surg 2014; 7886 (14) 73
    PubMedSearch in Google Scholar
  • 28 Zhou WP, Lai EC, Li AJ , et al. A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma. Ann Surg 2009; 249 (2) 195-202
    CrossrefPubMedSearch in Google Scholar
  • 29 Sun JH, Wang LG, Bao HW , et al. Emergency embolization in the treatment of ruptured hepatocellular carcinoma following transcatheter arterial chemoembolization. Hepatogastroenterology 2010; 57 (99-100) 616-619
    PubMedSearch in Google Scholar