Hepatocellular carcinoma complicated by hemothorax.

Although hemoperitoneum is a well-known cause of death induced by rupture of hepatocellular carcinoma (HCC). hemothorax caused by rupture of HCC has not been adequately described. We report here a 64-year-old woman who died of bleeding from pleural wall metastasis of HCC. She presented with liver failure and sudden-onset hypotension, and on the same day, she died of hypovolemic shock associated with liver failure. Autopsy revealed HCC metastatic to the lungs and right pleura and 21 of bloody pleural effusion in the right side. The cut surface of the metastatic nodule in the right pleura was filled with coagulated blood and necrotic tissue. We concluded that the pleural metastasis had ruptured and caused the right hemothorax. We discuss reported cases of HCC complicated by hemothorax.