Ruptured Hepatocellular Carcinoma Secondary to Undiagnosed Hepatitis B in a Young Male Papua New Guinean Patient

David Brough; Dominique  Dahlenburg; Adam McNamara; Amirah  Etchegaray; Emily Olive; David Cavallucci; Richard Bryant; Samuel Davis; Samuel Foong; Barbara Leggett; Nicholas O'Rourke

doi:10.64292/hpbci.160

Authors

David Brough Department of Hepatobiliary Surgery, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; School of Medicine, University of Queensland, Queensland 4006, Australia https://orcid.org/0000-0002-3063-8983
Dominique Dahlenburg Department of Hepatobiliary Surgery, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; School of Medicine, University of Queensland, Queensland 4006, Australia https://orcid.org/0009-0007-8391-4631
Adam McNamara Department of Hepatobiliary Surgery, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; School of Medicine, University of Queensland, Queensland 4006, Australia https://orcid.org/0000-0002-2900-4377
Amirah Etchegaray School of Medicine, University of Queensland, Queensland 4006, Australia; Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Queensland 4029, Australia
Emily Olive Department of Hepatobiliary Surgery, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; School of Medicine, University of Queensland, Queensland 4006, Australia
David Cavallucci Department of Hepatobiliary Surgery, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; School of Medicine, University of Queensland, Queensland 4006, Australia https://orcid.org/0000-0003-2112-6465
Richard Bryant Department of Hepatobiliary Surgery, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; School of Medicine, University of Queensland, Queensland 4006, Australia
Samuel Davis Department of Interventional Radiology, Royal Brisbane and Women's Hospital, Queensland 4029, Australia
Samuel Foong Department of Anatomical Pathology, Royal Brisbane and Women's Hospital, Queensland 4029, Australia
Barbara Leggett School of Medicine, University of Queensland, Queensland 4006, Australia
Nicholas O'Rourke Department of Hepatobiliary Surgery, Royal Brisbane and Women's Hospital, Queensland 4029, Australia; School of Medicine, University of Queensland, Queensland 4006, Australia https://orcid.org/0000-0003-0744-2816

DOI:

https://doi.org/10.64292/hpbci.160

Keywords:

Hepatocellular carcinoma (HCC), Hepatitis B

Abstract

A 29-year-old male from Papua New Guinea (PNG) presented to a rural Australian hospital with acute severe chest and abdominal pain. ECG did not demonstrate acute ischemic changes; however, cardiac troponin was raised, and he was initially managed as acute coronary syndrome with dual antiplatelet therapy and therapeutic anticoagulation. He subsequently developed worsening abdominal pain and a hemoglobin decrement. Computed Tomography (CT) Angiogram of the abdomen demonstrated a large mass in the right lobe of the liver with hemoperitoneum. Serology revealed active Hepatitis B, with liver biopsy confirming hepatocellular carcinoma. Following multidisciplinary team discussion, he underwent palliative locoregional treatment with Selective Internal Radiation Therapy (SIRT).

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