Spontaneous rupture of hepatic metastasis from a thymoma: A case report

Abstract

Bleeding resulting from spontaneous rupture of the liver is an infrequent but potentially life threatening complication that may be associated with an underlying liver disease. A hepatocellular carcinoma or hepatic adenoma is frequently reported is such cases. However, hemoperitoneum resulting from a hepatic metastatic thymoma is extremely rare. Here, we present a case of a 62-year-old man with hypovolemic shock induced by ruptured hepatic metastasis from a thymoma. At the first hospital admission, the patient had a 45-mm anterior mediastinal mass that was eventually diagnosed as a type A thymoma. The mass was excised, and the patient was disease-free for 6 years. He experienced sudden-onset right upper quadrant pain and was again admitted to our hospital. We noted large hemoperitoneum with a 10-cm encapsulated mass in S5/8 and a 2.3-cm nodular lesion in the right upper quadrant of the abdomen. He was diagnosed with hepatic metastasis from the thymoma, and he underwent chemotherapy and surgical excision.

Ruptured metastatic liver tumor secondary to a thymoma: a case report

“…Rupture of a metastatic liver tumor, as seen in our case, is even rarer. To the best of our knowledge, only one previous report of rupture of a metastatic liver tumor from thymoma has been reported [ 2 ]. In that case, the liver metastasis was detected metachronously from the primary thymic tumor and liver resection was performed after four cycles of chemotherapy [ 2 ].…”

“…Tumor metastasis from a thymoma to the liver is relatively rare [ 1 ], and rupture of such a tumor is even more rare, with only one such case being previously reported [ 2 ]. The rupture of the tumor is a more likely situation in patients with hepatocellular carcinoma or lymphoma [ 3–6 ].…”

Haemoperitoneum Due to Spontaneous Rupture of a Liver Metastasis

“…Patients with ongoing bleeding and oligometastatic liver disease with a good performance status are the most promising candidates for this approach. Surgical resection of liver metastasis carries significant mortality in the emergency setting but may be considered after haemostasis has been achieved, especially in cases of solitary liver metastasis [ 3 , 5 ] .…”

Massive hemoperitoneum and upper gastrointestinal hemorrhage following liver rupture secondary to gallbladder perforation

“…The condition has a worldwide incidence between 2.3% and 26% and a mortality rate of 25% to 100%. [ 1 – 4 ] Determining the etiology of spontaneous liver rupture enables the treating physician to determine the required treatment strategy. For patients with unresectable ruptured cancers, transcatheter hepatic arterial chemoembolization (TACE) may be the only choice.…”