2023 Volume 38 Issue 1 Pages 73-81
A 42-year-old man presented with appetite-loss, abdominal discomfort and weight-loss. Enhanced CT scan revealed a tumor in the pancreatic head, hepatic hilar lymphadenopathy and a liver tumor with a final diagnosis of pancreatic carcinoma with liver metastasis and lymph node metastasis (T3N1M0 Stage IV). There was obstructive jaundice due to hilar adenopathy. Endoscopic drainage was performed for obstructive jaundice which led to resolution of jaundice and hospital discharge. Ten days later he presented with upper abdominal pain. Enhanced CT scan showed rupture of a liver metastasis from pancreatic carcinoma. Emergency transcatheter arterial embolization was performed to control bleeding. Chemotherapy was administered after bleeding was controlled. Rupture of metastatic liver lesions are rare, and there are only five previous reports of ruptured lesions from pancreatic cancer. In the present patient, there was a rapid increase in the liver metastasis, and blood vessel collapse due to increased intratumor pressure was suspected.
