A case of ruptured hepatocellular carcinoma immediately after transcatheter arterial chemoembolization

Spontaneous rupture of hepatocellular carcinoma(HCC)is well known. However, rupture of HCC after transcatheter arterial chemoembolization(TACE)is a rare but potentially fatal complication. Herein, we report a case of ruptured HCC after TACE in a 73-year-old man with chronic liver injury(non-B and non-C).He had previously undergone subsegmental resection of S7 of the liver for HCC. One year later, multiple HCCs were detected. TACE was performed for the recurrent HCCs located on the surface of S2 of the liver. Epigastric pain and decreased blood pressure were observed after the treatment. Although his symptoms improved immediately, the patient gradually became anemic. Radiological examination after TACE revealed a hematoma around the S2 lesion. Therefore, we diagnosed rupture of HCC. We performed TAE and could control the bleeding. Few possible mechanisms of ruptured HCC after TACE include increasing pressure inside the tumor and capsular injury due to TACE. Consequently, HCC which has a high risk of rupture after TACE should be assured embolization and careful observation.