Rupture of a hepatic metastasis from renal cell carcinoma

We describe a rare case of spontaneous rupture of a hepatic metastasis from renal cell carcinoma that was treated successfully by hepatic arterial emb olization. A 65-year-old woman, who had been undergoing immunotherapy for i noperably disseminated renal carcinoma and lung metastases, presented with severe abdominal pain in a state of hypovolemic shock. Computed tomography revealed a highly attenuated mass lesion in the right lobe of the liver and massive intraperitoneal hemorrhage. Subsequent hepatic angiography showed extravasation from the feeding right hepatic artery. Transcatheter emboliza tion of the right hepatic artery was subsequently performed, and the patien t made an uneventful recovery. Although hepatic rupture due to metastatic c ancer is extremely rare, transcatheter arterial embolization (TAE) is an ap propriate and useful treatment for massive hemorrhage caused by spontaneous rupture of liver metastasis. (C) 2000 Elsevier Science Inc All rights rese rved.