A case of hepatocellular carcinoma in an elder man with metastasis to the nasopharynx.

The lung, bone, brain, etc are common metastatic sites of hepatocellular carcinoma. Nasopharynx metastasis of hepatocellular carcinoma rarely occurs and has not been reported yet. Here we report one case of nasopharynx metastasis from liver in a 50-year-old male patient who was diagnosed with primary hepatocellular carcinoma (nodular and diffuse-type) in 2014. 6 and underwent interventional therapy for two times afterward. However, he suffered from severe headache in 2014. 8, and head contrast-enhanced MRI scan did not show clues for brain or skulls metastasis. Then the lumbar puncture was performed to examine his cerebrospinal fluid (CSF). It showed that cerebrospinal fluid protein (AFP) was extremely higher than the normal level. Then, he developed left blepharoptosis, eye opening obstacle, impaired vision and dysphagia. Positron emission tomography CT (PET-CT) showed that there was multiple bone destruction in skull base, indicating the nasopharyngeal cancer which was proven to be the metastatic tumor from liver histologically by biopsy. Finally, this patient underwent radiotherapy (RT) of nasopharyngeal metastatic tumor and the local symptoms changed for the better.