An Oncologic Emergency: A Case of Mixed Hepatocellular Carcinoma and Hepatoblastoma Tumor with Intraperitoneal Hemorrhage Caused by Tumor Rupture

Abstract

A 10-year-old boy was taken to a neighborhood hospital with acute abdominal pain and vomiting, and was diagnosed as having hemorrhagic shock. Abdominal CT revealed rupture of a liver tumor, and the child was transferred to our hospital. We decided to perform an interventional radiologic procedure (IVR) prior to surgery, to stabilize the hemodynamic status of the patient, and performed embolization of the tumor feeding arteries. Thereafter, hepatic resection was performed on day 7 after admission. The postoperative clinical course was favorable. The histopathological diagnosis of the tumor was mixed hepatocellular carcinoma with hepatoblastoma, and the patient was initiated on postoperative chemotherapy. This case underscores the importance of selecting the appropriate treatment, including surgical procedure or IVR, for pediatric cases of liver tumor with intraperitoneal hemorrhage presenting as an oncologic emergency.