title: [A case of hepatocellular carcinoma presented as a huge intrahepatic hematoma].
abstract: Spontaneous intrahepatic bleeding is a rare condition. In the absence of trauma, intrahepatic hematoma may be due to underlying liver disease. We report a case of hepatocellular carcinoma in the patient who had huge intrahepatic hematoma without definite intrahepatic tumor at the time of initial presentation. A 54-year-old man was admitted to our hospital with a sudden onset of upper abdominal pain. Initial abdominal CT scan showed huge hematoma measuring more than 13 cm in diameter in the right lobe of the liver. However, there was no enhancing lesion in the liver. Laboratory data showed high alanine aminotransferase, alpha-fetoprotein and positive HBsAg. The MRI and angiography could not also depict any mass in the liver. The patient was treated with percutaneous drainage on the intrahepatic hematoma. The cytology from drainaged blood revealed no malignant cell. After hematoma decreased, follow-up CT scan depicted an enhancing tumor in the liver. He underwent right hepatic lobectomy and histopathological examination showed hepatocellular carcinoma.
authors.affiliation: Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Won Sang
authors.initials: WS
authors.lastname: Yoo
authors.forename: Nam Hee
authors.initials: NH
authors.lastname: Kim
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Kang
authors.forename: Se Young
authors.initials: SY
authors.lastname: Yun
authors.forename: Suk Bae
authors.initials: SB
authors.lastname: Kim
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Shin
authors.forename: Yun Chan
authors.initials: YC
authors.lastname: Park
authors.forename: Il Han
authors.initials: IH
authors.lastname: Song
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed