Ruptured hepatic sarcoma as a cause of acute abdomen

A 24-year-old male patient, in study for a hepatic tumor, was admitted to emergency due to hypovolemic shock and anemia. The abdominal CT scan showed an extensive expansive lesion of 11.8x11.7cm in liver segments II and III with rupture signs and lamellar hyperdense component of haematic and necrotic aspect, associated with free fluid in the abdominal cavity (Fig 1.A). The tumor markers (DHL, AFP, CEA) and viral serology were negative. The patient was submitted to surgery, an exploratory laparotomy + Pringle maneuver + II and III hepatic segmentectomy was performed. Abundant intra-abdominal blood was evidenced, and an extensive multilobed 20x20cm tumor dependent on II and III hepatic segments, a R2 surgery was achieved. The histological study showed a non-classifiable high grade sarcoma, CD56 positive (Fig. 1.B). The patient was discharged after 7 days.