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Copyright ©The Author(s) 2021.
World J Gastroenterol. May 21, 2021; 27(19): 2299-2311
Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2299
Table 1 Cases of spontaneous rupture of hepatic angiomyolipoma
Ref.
Sex
Age, yr
Symptoms
Abdominal radiological findings
Treatment
Outcomes
Huber et al[25] 1996F22Hemorrhagic shock with clinical symptoms of acute abdomenCT scan: multiple tumors of the liver (the largest in segment III measured 8 cm) and both kidneys and a splenic lesion with a diameter of 4 cmSurgical resection of segments II and IIIPostoperative course was uneventful. Discharge from hospital 12 d later
Guidi et al[26] 1997M74Sudden onset of upper-quadrant painCT scan: liver tumor of 10 cm × 8 cm in the segments I and V and another small mass of 4 cm × 3 cm in segment IV. Fluid was present in the upper abdominal compartmentsSurgical resection of the hemorrhagic hepatic massPostoperative course was uneventful. Discharge from hospital 8 d later
Tsui et al[27] 1999F41Acute rupture of a subcapsular tumor9 cmSurgical resectionPatient in healthy condition 4 yr after surgery
Zhou et al[28] 2008NDNDHemorrhagic shockUltrasonography showed a 5-cm "cavernous hemangioma" in the right hepatic lobeEmergency laparotomy for hemostasisNo tumor recurrence or metastasis was found during follow-up of 2-3 yr
Ding et al[8] 2011F56NDA rupture of the tumor measuring 6 cm × 6 cm in segment VI was confirmed by emergent laparotomyLiver suture followed by segmentectomyNo serious morbidity in the postoperative course
Occhionorelli et al[29] 2013F25Sudden onset of abdominal upper-quadrant pain and hypotension, after two recent syncopal episodesCT scan showed a hepatic tumor in the left lobe (8.6 cm × 7.2 cm) with suspected peritoneal blood leakageHemorrhage initially managed by manual compression, followed by deep and pro-coagulant tissue adhesives. After 48 hours, the patient underwent left-liver lobectomyPostoperative course was uneventful. Discharge from hospital 9 d later
Aoki et al[30] 2014F70Sudden onset of back pain on the right sideCT scan: hepatic tumor in segment VII measuring 7 cm in diameter accompanied by subcapsular hematoma with extravasationTranscatheter arterial embolization. Right hepatic lobectomy was carried out 39 d laterFive days after surgery, she had thrombi in the left popliteal vein and the left pulmonary artery. Insertion of an IVC filter which was removed due to sepsis. She was discharged 24 d after surgery. There was no recurrence 42 mo following surgery
Tajima et al[31] 2014M38Upper abdominal painCT scan showed a tumor measuring 10.5 cm × 9.5 cm × 7 cm in the posterior segment of the right hepatic lobe that had ruptured into the space between the liver and the diaphragmTranscatheter arterial embolization was performed. The patient developed fever and the hematoma surrounding the liver was drained. No infection was confirmed but right lobectomy was performedND
Kai et al[32] 2015F77Sudden abdominal pain and transient loss of consciousnessCT scan: hemoperitoneum with subcapsular hematoma at the left lobe and a hepatic nodule measuring 2.3 cm in diameter in segment IIConservative initial treatment with periodic imaging studies. Transcatheter arterial chemoembolization was performed because a diagnosis of HCC was suggested. Surgical resection (laparoscopic left lateral segmentectomy) was performed 4 mo laterPostoperative course was uneventful. Discharge from hospital 7 d later No signs of recurrence at 3.5 yr after surgery
Kim et al[33] 2017M31Sudden onset severe abdominal pain in the right upper quadrant areaCT scan: Mass of approximately 12 cm in the right hepatic lobe with hemorrhage along the perihepatic spaceEmergent angiography with embolization.Hepatic resection was performed 15 d laterPostoperative course was uneventful