Spontaneous Rupture of Hepatocellular Carcinoma: Pathogenesis, Clinical Management, Prognostic Factors, and Future Directions

Spontaneous rupture of hepatocellular carcinoma (srHCC) is a life-threatening complication with complex pathophysiology and heterogeneous clinical presentations. This review aims to provide an up-to-date summary of the pathogenesis, clinical features, treatment strategies, prognostic factors, and emerging research in srHCC. We discuss current understanding of risk factors and rupture mechanisms, outline diagnostic and therapeutic approaches-including surgical, interventional, and systemic options-and explore postoperative management and prognosis. We also highlight recent clinical evidence and unmet research needs. Understanding the multifaceted nature of srHCC is essential to improve outcomes and guide future research directions.