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Norman B. Ackerman, MD, PhD; Manohar N. Nallathambi, MD; Kumar R. Patel, MD; Pathmini Panchacharam, MD; Susan E. Williams, MD

Arch Surg. 1986;121(6):726-728.

Abstract
• A patient underwent a left-sided hepatic lobectomy for primary hepatocellular carcinoma 13 years ago and remained symptom free. He then presented with spontaneous rupture of a large tumor in the right lobe of the liver. Although this tumor proved to be primary hepatocellular carcinoma, there were significant histological differences between the two lesions, suggesting that this was a second primary liver tumor. Bleeding from the tumor was controlled by selectively ligating the branches supplying the area of hemorrhage.

(Arch Surg 1986;121:726-728)

Author Affiliations
From the Departments of Surgery (Drs Ackerman, Nallathambi, and Patel), Pathology (Dr Panchacharam), and Gastroenterology (Dr Williams), Metropolitan Hospital Center and New York Medical College, New York.

Footnotes
Accepted for publication Oct 30, 1985.

Reprint requests to Department of Surgery, Metropolitan Hospital Center, 1901 First Ave, New York, NY 10029 (Dr Ackerman).

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