Spontaneous hemoperitoneum secondary to rupture of hepatic metastasis from primitive neuroectodermal tumor: A case report and review of the literature

Spontaneous hemoperitoneum secondary to rupture of hepatic malignancy is rarely diagnosed preoperatively. High suspicion is required, followed by abdominal ultrasonography and abdominal computerized tomography. Hepatic metastasis from the central nervous system is rare, and has been exclusively found through autopsy. This report concerns a metastatic hepatic tumor from a primitive neuroectodermal tumor (PNET) which clinically manifested as hemoperitoneum. Such these patients usually survive only weeks to months after diagnosis. Selective hepatic artery ligation can effectively control tumor bleeding without increasing morbidity and mortality after operation, and this procedure is thus recommended as management of choice for this critical, emergency condition. If a diagnosis of rupture of metastatic tumor of liver can be established before laparotomy, catheter embolization of the hepatic artery is an alternative.