Metastatic hepatocellular carcinoma of the nasal septum treated with palliative radiofrequency ablation

Abstract

Metastasis of hepatocellular carcinoma (HCC) to the nasal septum is extremely rare. The proper management of this rare condition has not been established. A 45‐year‐old male had been treated for HCC for 5 years. He presented with right‐sided nasal obstruction. He had lung metastasis, and had been undertaking chemotherapy. On endoscopic examination, a 1.5 cm‐sized mass on the anterior nasal septum was observed. Biopsy taken from the septal mass revealed HCC, but he refused further intervention. Six months later, the mass grew and totally obstructed the right nasal cavity. For palliative treatment, radiofrequency ablation to the septal mass was done. At the 4‐month postoperative follow up, the septal mass had disappeared and septal perforation was noted on endoscopic examination and computed tomography of the paranasal sinus. One month later, the mass recurred in the upper lip; this lesion had not been previously recognized. His general condition rapidly deteriorated and he eventually died. Metastatic HCC should be considered in the differential diagnosis of nasal septal masses. Radiofrequency ablation might be a feasible palliative treatment option in the treatment of metastatic septal lesions if a target lesion is properly located.