Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2016; 22(44): 9860-9864
Published online Nov 28, 2016. doi: 10.3748/wjg.v22.i44.9860
Spontaneous rupture of hepatic metastasis from a thymoma: A case report
Ho Jae Kim, Yong Eun Park, Min Seo Ki, Se Ju Lee, Seung Hun Beom, Dai Hoon Han, Young Nyun Park, Jun Yong Park
Ho Jae Kim, Yong Eun Park, Min Seo Ki, Se Ju Lee, Seung Hun Beom, Jun Yong Park, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea
Dai Hoon Han, Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, South Korea
Young Nyun Park, Department of Pathology, Yonsei University College of Medicine, Seoul 120-752, South Korea
Author contributions: Park YE, Lee SJ and Park YN analyzed the data; Kim HJ, Ki MS, Beom SH, Han DH and Park JY treated the patient; Kim HJ and Park JY wrote the paper.
Institutional review board statement: This study was performed in accordance with the ethical guidelines of the 1975 Declaration of Helsinki and approved by the institutional review board of Severance Hospital. A written informed consent was not required due to the retrospective nature of this study.
Informed consent statement: The patient reported in this article provided informed written consent prior to manuscript preparation.
Conflict-of-interest statement: There is no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jun Yong Park, MD, PhD, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, South Korea. drpjy@yuhs.ac
Telephone: +82-2-22281998 Fax: +82-2-3936884
Received: June 30, 2016
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
Abstract

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.

Keywords: Spontaneous rupture, Hemoperitoneum, Transarterial chemoembolization, Hepatic metastasis, Thymoma

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.