[Acute haemoperitoneum due to spontaneous tumour rupture as first manifestation of hepatocellular carcinoma].

HCC rupture with potentially fatal haemoperitoneum is not an infrequent complication of primary hepaotcellular carcinoma with a prevalence between 2.9 and 26 % and must be considered in the differential diagnosis in all patients with acute haemoperitoneum. Spontaneous tumour rupture is the most common cause, although the pathogenesis of it is not completely understood. Because of the high mortality of an emergency tumour resection, it appears that a two-stage treatment approach with emergency TAE and subsequent elective hepatic resection is the safest and most effective strategy for the management of this life-threatening situation. Despite all therapeutic efforts, the prognosis of this severe complication still remains poor. We report on a 82-year-old patient with spontaneous tumour rupture as the first manifestation of liver cell carcinoma. Our patient represents an exception because his spontaneous HCC rupture occurred without concomitant liver cirrhosis. According to our knowledge this case report is the first publication on spontaneous HCC rupture without pre-existing liver cirrhosis.