# Silent Hemoperitoneum Unveils Advanced Cancer

## TL;DR

A man on peritoneal dialysis was found to have advanced liver cancer after sudden blood in his dialysate, highlighting the need for early cancer detection in such patients.

## Contribution

This case highlights hemoperitoneum as a rare but critical sign of advanced hepatocellular carcinoma in PD patients.

## Key findings

- A 4.4 cm liver tumor was diagnosed as ruptured hepatocellular carcinoma (stage IIIB T4N0M0).
- Laparoscopic segmentectomy was successfully performed, and dialysis resumed after a month.
- Hemoperitoneum in PD patients should prompt consideration of malignancy for timely cancer detection.

## Abstract

A 62-year-old male undergoing peritoneal dialysis (PD) for over two years presented with sudden bloody peritoneal dialysate, but no other symptoms. Laboratory tests indicated anemia, and a computed tomographic scan revealed a 4.4 cm tumor in the liver with hemoperitoneum, leading to a diagnosis of ruptured hepatocellular carcinoma (HCC), stage IIIB T4N0M0. The patient underwent a successful laparoscopic segmentectomy, and PD was resumed after a month of hemodialysis without complications. This case underscores the importance of considering malignancy in PD patients presenting with hemoperitoneum, as timely detection of HCC can significantly improve prognosis.