Rombolà Ferdinando, Caravetta Angelo, Mollo Francesco, Spinoso Antonio, Peluso Lenino, Guarino Raffaele
Emergency Medicine Unit, "Jazzolino" Hospital, Vibo Valentia, Italy.
Acta Medica (Hradec Kralove). 2011;54(4):177-9. doi: 10.14712/18059694.2016.46.
Spontaneous rupture is a rare and dramatic complication ofhepatocellular carcinoma (HCC), burdened by a high mortality. Here we describe a case of a 73-year-old man, who arrived at the ER because of syncope, and acute epigastric and right upper quadrant abdominal pain. He had a history of hepatitis C-related liver cirrhosis and HCC in treatment with sorafenib. The physical examination showed a state of hemorrhagic anemia with the presence of blood in the peritoneal cavity. The patient underwent an urgent liver resection. Thirty days after surgery, he was in good general condition. Sorafenib is a multikinase inhibitor recently introduced in the therapy of patients with advanced HCC. Among the various side effects reported in patients treated with sorafenib, there is a higher risk of bleeding. In conclusion, sorafenib may increase the risk of bleeding and rupture of HCC in susceptible individuals.
自发性破裂是肝细胞癌（HCC）一种罕见且严重的并发症，死亡率很高。在此我们描述一例73岁男性患者，因晕厥以及上腹部和右上腹急性疼痛而急诊入院。他有丙型肝炎相关肝硬化病史，正在接受索拉非尼治疗HCC。体格检查显示有出血性贫血状态，腹腔内有血液。患者接受了急诊肝切除术。术后30天，他的一般状况良好。索拉非尼是一种最近用于晚期HCC患者治疗的多激酶抑制剂。在用索拉非尼治疗的患者中报告的各种副作用中，出血风险较高。总之，索拉非尼可能会增加易感个体中HCC出血和破裂的风险。
