Imagen de carcinomatosis peritoneal secundaria a rotura de carcinoma hepatocelular originado sobre hígado sano

This is a female, 34 years, who presented with pain at the right iliac fosse and pre-syncopal symptoms. As background, she has undergone a right ovarian cystectomy due to a serous cystadenoma several years ago and appendectomy. At physical examination she had signs of peritoneal irritation and heterogeneous free fl uid was detected on ultrasound, suggesting hemoperitoneum, so urgent laparotomy was decided. A peripheral liver tumor was seen in segment VII, it was partially removed and pathological diagnosis was hepatocellular carcinoma (HCC). At that time, liver function tests and alpha-fetoprotein were within normal limits and hepatitis B and C virus serology were negative. The patient was moved to a referral centre, where a triphasic liver CT and MR-angiography (Fig. 1) were performed. small remaining tumor was observed within segment VII of the liver, without distance disease, so a formal resection of segment VII was made. The specimen showed a grade II HCC, 20 mm of diameter, with a satellite 1 mm away, without vascular invasion (Fig. 3A). No systemic or local therapy as secondary prophylaxis was administered. The fourth-month follow-up control showed multiple peritoneal implants