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01.12.2012 | Case report | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Hemothorax caused by spontaneous rupture of hepatocellular carcinoma: a case report and review of the literature

World Journal of Surgical Oncology > Ausgabe 1/2012
Fuminori Ono, Masaki Hiraga, Noriyuki Omura, Manabu Sato, Akihiro Yamamura, Megumi Obara, Jun Sato, Shoichi Onochi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-215) contains supplementary material, which is available to authorized users.

Competing interests

Fuminori Ono and other co-authors have no competing interests.

Authors’ contributions

FO performed TAE and surgery. FO also drafted the manuscript. Other authors helped to draft the manuscript. All authors read and approved the final manuscript.


We report a rare case in which hemothorax occurred in addition to hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma (HCC) originating from the caudate lobe of the liver. The case pertains to a 56-year-old female who was transported to our hospital for impaired consciousness due to hemorrhagic shock. Computed tomography (CT) demonstrated ruptured HCC originating from the caudate lobe and accompanying hemoperitoneum and right hemothorax. Hemostasis was carried out by transcatheter arterial embolization (TAE), and surgery was conducted approximately one month after TAE. In the present case, no lesions as possible sources of bleeding were observed inside the pleural cavity, and, moreover, the diaphragm had no abnormalities in the intraoperative findings, suggesting that blood from the ruptured tumor may have traversed the intact diaphragm to enter the right pleural cavity soon after the HCC rupture. However, to the best of our knowledge, no similar cases of HCC have been reported to date, and this case is thus believed to be very rare. This unusual phenomenon may therefore be strongly associated with the location of the ruptured tumor and the formation of a hematoma inside the omental bursa. We discuss the mechanism causing hemothorax in the present case and also review the previously reported cases of ruptured HCC complicated by hemothorax.
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