Management of ruptured liver segment IV hepatocellular carcinoma: is transarterial embolization (TAE) superior to chemoembolization (TACE)? —the jury is still out

HCC rupture is a potentially life-threatening complication owing to underlying vascular dysfunction and coagulopathy. There is still a debate in the literature concerning the best approach in patients presenting in the emergency setting with shock due to spontaneous HCC rupture. In the current report, we describe the case of a 66-year-old female patient with ruptured HCC who was treated successfully by emergency transarterial embolization (TAE) with complete response proved by gradual shrinkage of the tumor. This impressive complete response suggests that TAE followed by elective hepatectomy could be an efficient approach for patients with Child-Pugh class A liver function and adequate liver remnant. More studies are needed in order to construct specific guidelines for the treatment of rHCC that will be based on the disease severity and the patient status.