Recurrence of Hepatocellular Carcinoma After Liver Transplantation Presenting with Massive Intrahepatic Bleeding

Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and is reported to be the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Liver resection and transplantation are the only curative treatment modalities, even though both techniques are marked by a relatively high rate of tumor recurrence. Whenever tumor recurrence develops as a new nodule, several strategies are available for diagnosis and treatment. However, massive bleeding in a transplanted liver due to recurrent ruptured HCC has never been reported. This kind of presenting pattern has several concerns for diagnosis and treatment.