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Plain English summary of Surgical resection of ruptured fibrolamellar hepatocellular carcinoma

Minutolo V, Licciardello A, Arena M, Minutolo O, Lanteri R, Arena G, Cae Reports in Surgery, 2013: PMID: 23956918

This is a case report of one male patient, 29 years old, who presented in the ER with sudden pain in the right upper abdomen, and was found to have a ruptured FL-HCC. His past medical history was completely unremarkable. The tumor, which measured 8 by 5 cm, ruptured, causing blood to spill into the abdomen, which in turn, caused intense pain by irritating the lining of the abdomen (“peritoneum”). The patient underwent emergency surgery to clear the hemoperitoneum (term for blood in the peritoneum) and to resect the tumor. He recovered but, six months after surgery, had recurrence of the tumor in both the liver and within the abdomen. He died 26 months after surgery. Tumor size greater than 5 cm has been associated with spontaneous rupture as in this case. Tumor rupture, and thus spillage of tumor into the abdomen, may very well have played a role in the patient’s recurrence and subsequent, death.