Enucleation Sign: A Computed Tomographic Appearance of Ruptured Hepatocellular Carcinoma

Rupture of hepatocellular carcinoma (HCC) is a catastrophic complication, which carries high mortality. We report a case of spontaneous rupture of HCC, diagnosis of which was considered on clinical presentation and confirmed on computed tomographic (CT) scan. On CT scan, characteristic 'enucleation sign' was observed on arterial phase imaging, where a hypervascular peripheral mass showing central necrosis was seen protruding from liver surface with discontinuity of hepatic parenchyma associated with high attenuation ascites.