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A Rare Case of Atraumatic Splenic Rupture Due to Metastatic Hepatocellular Carcinoma

Dang Quang Hung1,#, Nguyen-Thi Nhan1, Trinh-Thi Phuong Nga1, Nguyen Thanh Hai1, Nguyen Quang Duc1, Nguyen Viet Thu1, Nguyen Truong Duc1, Dinh-Van Thuyet1, Nguyen Minh Duc2,#,*,ORCID

1 Department of Radiology, Vinmec Healthcare System, Ha Noi, Viet Nam
2 Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
# These authors contributed equally to this article as co-first authors
ORCID ID: 0000-0001-5411-1492

* Corresponding Author:Nguyen Minh Duc. Email:

Oncologie 2021, 23(4), 603-608.


Metastatic spread of hepatocellular carcinoma (HCC) to the spleen is uncommon, only occurring in approximately 1% of cases. Atraumatic splenic rupture due to HCC metastasis is extremely rare and affects patient prognosis, clinical management, and mortality. We report a case of a 65-year-old man with a history of chronic hepatitis B infection who presented with left-sided abdominal pain and fatigue. Clinical examination showed acute anemia with elevated levels of serum alpha-fetoprotein (AFP) and protein induced by vitamin K absence (PIVKA-II). On ultrasound and computed tomography imaging, hemoperitoneum caused by a ruptured splenic tumor was revealed. In addition to multiple hepatic lesions, enlarged abdominal lymph nodes and osteolytic lesions in the thoracic vertebral bodies were detected. The patient underwent total splenectomy and was diagnosed histopathologically with splenic rupture secondary to Grade 2 HCC metastasis. Atraumatic, pathological splenic rupture due to HCC metastasis should be considered in patients with chronic hepatitis B or C infection and increasing serum AFP and PIVKA-II levels, even though splenic metastasis is uncommon.


Cite This Article

Hung, D. Q., Nhan, N., Nga, T. P., Hai, N. T., Duc, N. Q. et al. (2021). A Rare Case of Atraumatic Splenic Rupture Due to Metastatic Hepatocellular Carcinoma. Oncologie, 23(4), 603–608.

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