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Spontaneous rupture of hepatocellular carcinoma during pregnancy
1Department of General Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan. h605@ms16.hinet.net
Background:
Hepatocellular carcinoma associated with pregnancy is unusual.
Case:
A 33-year-old woman presented at 25 weeks' gestation with sudden, severe epigastric pain for 6 hours. Abdominal ultrasonography and magnetic resonance imaging showed multiple liver tumors with a small amount of ascites. Exploratory laparotomy revealed an unresectable ruptured liver tumor that was treated by packing. Although a biopsy was nondiagnostic, ultrasound-guided needle biopsy 6 days after cesarean delivery at 41 weeks' gestation showed hepatocellular carcinoma, which was treated with transarterial embolization. At 3.5 years posttherapy, both mother and infant are well.
Conclusion:
Ruptured hepatocellular carcinoma during pregnancy is rare but should be included in the differential diagnosis of sudden, severe epigastric pain.
