Synchronous hepatocellular carcinoma and nasopharyngeal carcinoma in a patient with chronic hepatitis B: A case report and literature review.
Shijie Zhang
✦ AI-curated · Sources linked
Case in brief
A 63-year-old Chinese man with chronic hepatitis B was found on routine screening to have a liver mass and reported nasal obstruction. Imaging showed a 46 × 59 mm hepatic lesion with portal vein tumor thrombus and a 41 × 29 mm nasopharyngeal mass with bilateral cervical lymphadenopathy. Biopsies identified moderately differentiated hepatocellular carcinoma and EBV-associated non-keratinizing nasopharyngeal carcinoma. During treatment with hepatic arterial infusion chemotherapy, tislelizumab, and donafenib, both tumors remained controlled at 19 months; the nasopharyngeal tumor met radiographic complete response criteria.
What made this case unusual
The case involved synchronous primary hepatocellular and EBV-associated nasopharyngeal carcinomas, with the latter achieving a radiographic complete response despite deferred radiotherapy.
Diagnostic / clinical pearl
A liver mass and nasal obstruction in a patient with chronic hepatitis B may reflect synchronous primary cancers; tissue confirmation established distinct hepatocellular and nasopharyngeal malignancies in this case.
Why it matters
The response cannot be attributed to any single treatment component, and the report emphasizes that definitive radiotherapy remains standard care for locoregionally advanced nasopharyngeal carcinoma.