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. 2016 Dec;6(4):335-336.
doi: 10.1016/j.jceh.2016.05.004. Epub 2016 May 24.

Enucleation Sign: A Computed Tomographic Appearance of Ruptured Hepatocellular Carcinoma

Manphool Singhal  1 , Upasna Sinha  1 , Naveen Kalra  1 , Ajay Duseja  2 , Niranjan Khandelwal  1
Affiliations

Enucleation Sign: A Computed Tomographic Appearance of Ruptured Hepatocellular Carcinoma

Manphool Singhal et al. J Clin Exp Hepatol. 2016 Dec.

Abstract

Rupture of hepatocellular carcinoma (HCC) is a catastrophic complication, which carries high mortality. We report a case of spontaneous rupture of HCC, diagnosis of which was considered on clinical presentation and confirmed on computed tomographic (CT) scan. On CT scan, characteristic 'enucleation sign' was observed on arterial phase imaging, where a hypervascular peripheral mass showing central necrosis was seen protruding from liver surface with discontinuity of hepatic parenchyma associated with high attenuation ascites.

Keywords: CT, computed tomography; HCC, hepatocellular carcinoma; contrast enhanced computed tomography; enucleation sign; hepatocellular carcinoma; rupture.

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Figures

Figure 1
Figure 1
Contrast-enhanced CT axial images in arterial phase show a peripheral mass, showing central necrosis (asterisk), protruding hypervascular mass from liver surface (thick arrow), and discontinuity of hepatic surface (thin arrows). Note high attenuation ascites consistent with hemoperitonium.
See this image and copyright information in PMC

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