Peritoneal Carcinomatosis From Ruptured Hepatocellular Carcinoma on Bone Scintigraphy

Abstract

A 76-year-old woman with a history of end-stage renal failure on continuous ambulatory peritoneal dialysis was admitted for suspected peritonitis. The patient failed to improve with antibiotics. An abdominal ultrasound showed a large mass in the right lobe of the liver and gross ascites. An elevated alpha-fetoprotein level was noted biochemically. A staging bone scan showed diffuse heterogeneous uptake in the abdomen, confirmed to be secondary to peritoneal metastases from hepatocellular carcinoma on computed tomography. This case illustrates a rare presentation of peritoneal metastases from hepatocellular carcinoma revealed on bone scintigraphy.