Related Experiment Video
Updated: Jul 10, 2026

Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Adrenal hemorrhage as the first presentation of hepatocellular carcinoma
Padiporn Vasinanukorn1, Rungsun Rerknimitr, Suvit Sriussadaporn
1Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok.
Abstract:
We report a 67-year-old man who presented with sudden onset of pain in the left flank in association with anemia and hypotension. Imaging studies revealed hepatocellular carcinoma (HCC) at the right lobe of the liver with bilateral adrenal metastases and recent hemorrhage in the left adrenal gland. His serology for hepatitis C was positive. Abdominal exploration with left adrenalectomy was performed. The postoperative course of the patient was uneventful and three cycles of transarterial chemoembolization (TACE) were administered. His general condition gradually deteriorated, and he died 6 months after surgery. Spontaneous massive AH due to metastatic HCC is unusual. Considering the high incidence of HCC in Asia, clinicians should be aware of this atypical and fatal presentation.
Related Concept Videos
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Portal Hypertension
Hemorrhagic Stroke l: Introduction
Cirrhosis I: Introduction
Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Cirrhosis II: Pathophysiology

