Traumatic Ruptured Hepatocellular Carcinoma Treated by Transcatheter Arterial Embolization Followed by Hepatic Resection

Traumatic ruptured hepatocellular carcinoma (HCC) is very rare, and only 16 cases have been reported, to our knowledge, in the English and Japanese literature. We report a new case, summarizing the 16 reported cases. A 69-year-old man was admitted to an emergency hospital due to shock after a traffic accident. Computed tomography (CT) demanstrated the rupture of HCC at segment 8 of the liver and transcatheter arterial embolization (TAE) was subsequently carried out. He recovered from the initial critical condition, and was transferred to our department for further treatment. Although HCC, 6cm in diameter, was detected in segment 8 of the liver, no viable HCC could be observed in CT, so he was discharged and carefully followed up. Seven months later, a few viable nodules were detected around the HCC treated by TAE. Segment 8 of the liver was anatomically excised together with the adhering omentum and diaphragm. Washing cytology in the abdominal cavity showed findings for cancer to be negative. Histologically, viable well-differenciated HCC was evident around the necrotic tumor. He was discharged on postoperative day 14 and remains alive 8 months after surgery with bone metastasis.