Published online Nov 28, 2016. doi: 10.3748/wjg.v22.i44.9860
Peer-review started: July 5, 2016
First decision: August 8, 2016
Revised: September 7, 2016
Accepted: September 14, 2016
Article in press: September 14, 2016
Published online: November 28, 2016
Bleeding resulting from spontaneous rupture of the liver is an infrequent but potentially life threatening complication that may be associated with an underlying liver disease. A hepatocellular carcinoma or hepatic adenoma is frequently reported is such cases. However, hemoperitoneum resulting from a hepatic metastatic thymoma is extremely rare. Here, we present a case of a 62-year-old man with hypovolemic shock induced by ruptured hepatic metastasis from a thymoma. At the first hospital admission, the patient had a 45-mm anterior mediastinal mass that was eventually diagnosed as a type A thymoma. The mass was excised, and the patient was disease-free for 6 years. He experienced sudden-onset right upper quadrant pain and was again admitted to our hospital. We noted large hemoperitoneum with a 10-cm encapsulated mass in S5/8 and a 2.3-cm nodular lesion in the right upper quadrant of the abdomen. He was diagnosed with hepatic metastasis from the thymoma, and he underwent chemotherapy and surgical excision.
Core tip: Spontaneous rupture of hepatic metastasis from a thymoma is extremely rare. This case report presents a rare case of spontaneous rupture of hepatic metastasis from a thymoma and describes its management. To our knowledge, no such case of rupture of a metastatic liver tumor associated with a thymoma has been reported previously.