Findings of ruptured hepatocellular carcinoma on computed tomography in Thailand

ABSTRACT

Background: A spontaneously ruptured hepatocellular carcinoma (HCC) carries an extremely poor prognosis and high mortality. In Thailand, the reported incidence of ruptured HCC was 12.4 % . Objective: To evaluate the computed tomography (CT) findings of ruptured HCC at King Chulalongkorn Memorial Hospital, Thailand. Methods: We reviewed the CT findings of 15 patients who were diagnosed as having a ruptured HCC and underwent CT scan of the upper abdomen. Two experienced radiologists analyzed the CT findings regarding the tumor’s size, tumor’s number, location, hepatic segment involvement, contour protrusion including appearance of the mass and ascites. Results: The study population consisted of 15 men with mean age of 57.4 years (27-78 years). All cases showed liver cirrhosis. All ruptured tumors were located at the periphery of the liver and had a protruding contour. The maximum diameter of the tumors ranged from 2.8-17.2 cm (mean 7.44 cm). Marginal disruption was seen in 9 cases (60 %). Five cases (33 %) presented with hematoma and high attenuation around the ruptured mass. All cases of ruptured HCC had ascites. Conclusion: The peripheral location, protruding contour, marginal disruption of the tumor with the background of a cirrhotic liver are highly suggestive of ruptured HCC.