Unusual presentation of a huge hematoma in the liver derived from a nasopharyngeal carcinoma

Abstract

Introduction: Nasopharyngeal carcinoma (NPC) has the propensity to develop distant metastases at a high rate and with poor prognosis. The metastatic sites are usually multifocal and involve the bones, lungs, liver and distant lymph nodes. The management of metastatic disease is essentially palliative and is based on radiochemotherapy. Methods: A 50-year old man with a huge hematoma in the liver derived from a diagnosed NPC was treated with intermittent drainage of the hepatic hematoma for abdominal decompression, and the cavity was packed with omentum. In addition, 2 suspected metastatic lesions were excised. Neoadjuvant radiochemotherapy followed by concurrent chemotherapy was administered. Results: After surgical treatment of the huge hematoma, the suspect sites in the liver were diagnosed as metastatic carcinoma, similar to the primary tumor. Several months later, bone metastatic lesions in the vertebra and ossiliaca dextra were detected due to distant metastasis. Conclusion: Treatment of metastatic NPC is essentially palliative and survival is usually poor.