title: Treatment of rupture of a liver metastasis from esophageal leiomyosarcoma.
abstract: We describe a case of rupture of a liver metastasis from esophageal leiomyosarcoma which was treated successfully by hepatic arterial embolization, thus facilitating hepatectomy. A 59-year-old woman who had previously undergone esophagectomy for leiomyosarcoma was admitted in a state of hypovolemic shock. Ultrasonography revealed multiple tumors in the left lobe of the liver and massive intraperitoneal hemorrhage, confirmed by paracentesis, possibly due to spontaneous rupture. Subsequent hepatic angiography showed extravasation from the tumor, and embolization of the feeding left hepatic artery was performed. After achieving hemostasis, a left hepatic lobectomy was carried out just beneath the reconstructed stomach tube. The patient made an uneventful recovery and remains well after one year. Emergency arterial embolization followed by hepatectomy is an appropriate treatment for patients with spontaneous rupture of liver metastases.
authors.affiliation: Department of Surgery, National Cancer Center Hospital, National Cancer Center Research Institute, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Takayama
authors.forename: H
authors.initials: H
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Tachimori
authors.forename: H
authors.initials: H
authors.lastname: Watanabe
authors.forename: H
authors.initials: H
authors.lastname: Furukawa
authors.forename: K
authors.initials: K
authors.lastname: Takayasu
authors.forename: M
authors.initials: M
authors.lastname: Sakamoto
authors.forename: M
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007890:Leiomyosarcoma / Q000556:secondary* / Q000628:therapy*; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D012422:Rupture, Spontaneous