The Hidden Time Bomb Explodes: A Previously Asymptomatic and Undiagnosed Hepatocellular Carcinoma Presenting as a Tumour Rupture

Inna Sekirov, Carrie Yeung, Allison C. Harris, Jennifer Montis, Albert Chang, Eric M. Yoshida. UBCMJ 2011 2(2):35-37.
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Hepatocellular carcinoma is the third leading cause of cancer-related death world-wide. Infection with hepatitis B virus is the strongest known risk factor for the development of hepatocellular carcinoma, especially in male patients. Regular surveillance is crucial for early detection of hepatocellular carcinoma as, in the absence of consistent follow-up, patients often present with advanced disease and sometimes with tumor rupture. We present here a case report of a patient from a high risk demographic—an African male infected with hepatitis B virus—whose initial presentation of hepatocellular carcinoma was that of a tumor rupture. We highlight the non-specific nature of his presentation and the importance of high clinical suspicion for hepatocellular carcinoma in patients from high-risk groups. We highlight that in the absence of timely recognition of this malignancy, especially at its advanced stage, a patient’s already scarce treatment options may become even more limited.
KEYWORDS: hepatocellular carcinoma, hepatitis B virus, tumour rupture, transarterial embolization