To identify imaging findings and characteristics of patients withacute hemorrhage ofhepatocellular carcinoma (HCC). Treatment and outcome are discussed. In this poster we will review the most common presentation of bleeding in a known HCC. The CT characteristics of the lesions will be discussed, as well as the short term outcome after bleeding.Furthermore we will discuss the most common treatment options of acute hemorrhage in HCC. The aim is to teach residents and radiologists, who are not so familiar with HCC, to recognize HCC and risk...

HCC is strongly associated with liver cirrhosis. Frequent causes of liver cirrhosis are the abuse of alcohol, chronic infection with hepatitis B and C virus and haemochromatosis. HCC, although relatively uncommon in western and northern Europe, is a common abdominal carcinoma worldwide. Incidence ranges from 3/100.000 in most of Europe to 35.5/100.000 in Eastern Asia [1]. Male to female ratio is 8:1 in high incidence areas and 2.5:1 in low incidence areas. Hemorrhage of HCC, is a rare but potentially life-threatening complication and a surgical...

Imaging findings: In our experience a rupturedHCC typically presents itself as a large inhomogeneous subcapsular mass with surrouding and intra-abdominal hematoma [Figs. 1,2, 5-12]. Frank extravasation of contrast is not always noted, but risk of rebleeding is high. Extravasation of contrast in our patient series was noted in only 48 % of patients. As stated before risk of rebleeding is high and pre-emptiveembolization should always be considered. Figures on the right are CT, MR and angiogram images of the same patient with a large HCC....

Subcapsular location and large tumor diameter are associated with acute hemorrhage of HCC. Portal vein trombosis and signs of portal hypertension don't seem to be closely associated with acute haemorrhage of HCC. Once a HCC ruptures transarterial embolization is usually the therapy of choice followed by chemoembolization after work-up of the patient. The culprit lesions are usually in an advanced state which precludes any surgery and percutaneous ablation. Hemorrhage of HCC seems to be a poor prognostic marker. In our patient group 11 of 23...

1.Uptodate.comEpidemiology and etiologic associations of hepatocellular carcinoma. 2. Casillas et al. Imaging of non-traumatic hemorrhagic Hepatic Lesions. Radiographics March-April 2000 vol. 20 no. 2. 3. Miyamoto et al. Spontaneous rupture of hepatocellular carcinoma: a review of 172 Japanese cases. Am J Gastroenterol 1991; 86: 67-71. 4. Staging and current Treatment of Hepatocellular Carcinoma. Radiographics October 2005. Vol 25. Special Issue. 5. Lencioni et al. Locoregional treatment of hepatocellular carcinoma. Radiology Jan 2012 Vol. 262 No. 1. 6. Bruix et al. Hepatology 2011 Vol. 53, No....

Diederik C. Bijdevaate Radiology Resident, Erasmus MC Rotterdam, The Netherlands. Email: [email protected] Tel.: +31 6 81 475 902