Abstract
Spontaneous rupture of hepatocellular carcinoma (HCC) is an uncommon and life-threatening condition that poses significant diagnostic and therapeutic challenges. This report describes the case of a 78-year-old man with no prior history of liver disease who presented with acute abdominal pain and hemoperitoneum. Imaging revealed a ruptured exophytic HCC lesion in hepatic segment II, which was confirmed during laparotomy. The patient underwent successful segment II resection following stabilization, and histopathological analysis confirmed a moderately differentiated HCC in a non-cirrhotic liver. The postoperative course was uneventful. This case highlights the importance of timely diagnosis, tailored management strategies, and multidisciplinary care in addressing the complexities of spontaneous HCC rupture, particularly in patients without underlying liver disease.