# Hepatic Tumor Rupture in Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders of the B-cell Type in a Patient With Chronic Rheumatoid Arthritis

## TL;DR

A 75-year-old woman with rheumatoid arthritis developed a ruptured liver tumor linked to immunodeficiency, successfully treated with arterial embolization.

## Contribution

First reported case of hepatic tumor rupture in iatrogenic B-cell lymphoproliferative disorder successfully managed with TAE.

## Key findings

- Patient on TNF inhibitors developed B-cell lymphoma with liver involvement.
- TAE successfully controlled bleeding from ruptured hepatic tumor.
- Case highlights rare complication of immunodeficiency-associated lymphoproliferative disorders.

## Abstract

A 75-year-old woman on tumor necrosis factor inhibitors for rheumatoid arthritis presented with hematemesis and a gastric biopsy revealed diffuse large B-cell lymphoma with possible bulky left liver tumor involvement. On the second day of treatment with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, the patient experienced abdominal pain followed by shock vitals. A contrast-enhanced computed tomography scan revealed a ruptured liver. Transcatheter arterial embolization (TAE) was performed to stop the bleeding. This is the first case of hepatic tumor rupture secondary to an iatrogenic immunodeficiency-associated lymphoproliferative disorder of the B-cell type that was successfully treated with TAE to achieve hemostasis.