PRIMARY CYSTIC KERATINIZING SQUAMOUS-CELL CARCINOMA OF THE LIVER IN APATIENT WITH TREATED NASOPHARYNGEAL CARCINOMA

Primary squamous cell carcinoma of the liver is very rare; only 18 cas es have been recorded. In the present report we document an additional case who had a unique history of stage III non-keratinizing nasophary ngeal carcinoma treated with a full course of radiotherapy in July 199 3. Two small hypoechoic cyst-like lesions in the left hepatic lobe wer e identified at the same time. In July 1995 the 50-year-old patient re ported to be suffering from abdominal fullness and tenderness. A large hypodense tumour was demonstrated in the left hepatic lobe by abdomin al echography. The patient was diagnosed as having metastatic carcinom a and received two courses of pre-operative chemotherapy followed by l eft lobectomy of the liver and resection of adherent tissues on 9 Augu st 1995. Pathological study demonstrated a large hepatic cystic kerati nizing squamous cell carcinoma, which most likely arose from a solitar y hepatic cyst. Tumour seedings, probably secondary to tumour rupture, were also revealed on the omentum, peritoneum and diaphragm. However, regional lymph nodes were free of tumour. Systemic work-up failed to demonstrate evidence of local recurrence of nasopharyngeal carcinoma, metastatic lesion or any second primary tumour site.