title: Unusual presentation of a huge hematoma in the liver derived from a nasopharyngeal carcinoma.
abstract: BACKGROUND
  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 essenti- ally 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 oss iliaca dextra were detected due to distant metastasis.
  
  
  CONCLUSIONS
  Treatment of metastatic NPC is essentially palliative and survival is usually poor.
authors.forename: Arben
authors.initials: A
authors.lastname: Mitrushi
authors.forename: Sokol
authors.initials: S
authors.lastname: Bilali
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000150:complications / Q000556:secondary* / Q000628:therapy; D059248:Chemoradiotherapy; D004322:Drainage; D006406:Hematoma / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy