Life-threatening haemorrhage from a sternal metastatic hepatocellular carcinoma

Rupture of the tumour is a catastrophic complication of hepatocellular carc inoma. The prognosis in patients with a ruptured hepatocellular carcinoma i s usually unfavourable. We describe a 46-year-old man who suffered from vis ible massive tumour haemorrhage due to a hepatitis B-related hepatocellular carcinoma that metastasized to the sternal bone. The prominent tumour mass was bulging over the anterior chest wall on the sternum of the patient, an d bled spontaneously. This episode of life-threatening haemorrhage was stop ped by surgical ligation of the bleeding site. Palliative radiotherapy shra nk the tumour mass size and prevented further possible bleeding. This is li kely to be the first reported case with a visible spontaneous tumour bleedi ng from a sternal metastatic hepatocellular carcinoma. (C) 2000 Blackwell S cience Asia Pty Ltd.