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Rapidly Lethal Ruptured Hepatocellular Carcinoma With Disseminated Peritoneal Carcinomatosis on FDG PET/CT

Islam, Zulqar BS*; Hausauer, Brett MD; Keshavamurthy, Jayanth MD; Pucar, Darko MD, PhD†,‡

doi: 10.1097/RLU.0000000000002650
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Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Hepatocellular carcinoma commonly metastasizes to lungs, lymph nodes, and bone. Although HCC usually occurs in setting of chronic liver disease due to alcoholism or HBV/HCV infection, the incidence of HCC arising from nonalcoholic steatohepatitis is increasing. We present a very unusual initial presentation of occult HCC with peritoneal carcinomatosis secondary to liver rupture in a 70-year-old man with known nonalcoholic steatohepatitis–cirrhosis, best appreciated on FDG PET/CT. Our patient died a few days later. Tumor rupture is a rare but usually rapidly lethal complication of HCC.

From the *School of Medicine, Medical College of Georgia at Augusta University

Department of Radiology and Imaging, Medical College of Georgia at Augusta University, Augusta, GA

Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, CT.

Received for publication March 22, 2019; revision accepted April 23, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Darko Pucar, MD, PhD, Department of Radiology & Biomedical Imaging, Yale School of Medicine, 333 Cedar St, New Haven, CT 06511. E-mail:

Online date: June 3, 2019

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