Liver cancer with huge nasal alar metastasis

A 29-year-old man was presented to the emergency department with a dull pain in the right upper abdomen for 2 days. He had a history of chronic infection with hepatitis B virus (HBV) for 11 years. The abdominal computed tomography (CT) scan showed multiple low-density nodules fused into a clump, with sizes ranging from approximately 6–13 cm in the left liver. Postoperative pathology confirmed advanced hepatocellular carcinoma with lung metastatic tumors. After 36 months’ systematic treatment, the patient experienced a nasal alar mass growing rapidly (Figure 1A,B). The CT scan of the paranasal sinus demonstrated a 33 mm × 24 mm mass on the left nasal alar (Figure 1C). The biopsy pathology was consistent with metastatic hepatocellular carcinoma (Figure 1D). The patient has received regular chemotherapy with good performance status recently. This is the first case of liver cancer with such a huge nasal alar metastasis.

Figure 1 Pictures of nasal alar metastatic mass (A,B); CT scan of the paranasal sinus showing a huge mass on the left nasal alar (C); pathological picture (HE, 100×) of nasal alar biopsy (D).

Acknowledgments

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Footnote

Provenance and Peer Review: This article was a standard submission to the journal Hepatobiliary Surgery and Nutrition. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.org/article/view/10.21037/hbsn-20-501/coif). The authors have no conflicts of interest to declare.

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