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Hepatocellular carcinoma (HCC) is a primary malignancy of the liver with up to half of cases suffering from extrahepatic metastasis in the later stages of the disease. Commonly reported and encountered metastatic sites include the lymph nodes, lung, bone, and adrenal glands. This is an effort to throw a spotlight on a rare case of metastatic HCC which presented to us as two distinct lesions in the nose. It focuses on the presentation and the steps that were taken to reach this rare and unusual diagnosis. It sparks interest from a clinical and histopathology perspective. Our cynosure is the findings of the case coupled with a probe on the possible routes of spread of HCC to sinonasal region.

Foreign body (FB) ingestion is commonly seen in the ear nose and throat (ENT) field, with different presentations and sequelae. FBs can arrest in the upper aerodigestive tract or continue further down into either the airway tract to the bronchus or the digestive tract to the intestines. The pathway of an FB depends on the size and shape of the FB and how sharp its edges are. Since the 20th century, the use of disposable stainless-steel needles in the oral cavity has proven to be an effective and safe method for performing various intraoral procedures like dental infiltration or a root canal wash. Complications from their use are rare. Generally, dental needle breakages are caused by patients biting the needle, incorrect injection techniques, or inadequate preventative measures. The sudden movement of a patient during a procedure is one of the most common causes of breakage. Occasionally, needles are swallowed during dental procedures such as a root canal. Here, we report a case of a patient that swallowed a broken needle during a dental procedure. A few days later, the patient presented with neck pain, swelling, and a FB sensation. When the patient presented, she claimed that her symptoms had onset after consuming a meal containing duck meat. Initially, the patient was diagnosed as having ingested a duck bone. However, intraoperatively, the FB was discovered to be an injection needle that had migrated from the throat to the neck.

Case seriesPatients: Male, 20 • Male, 4 • Male, 27 • Male, 25 • Female, 5 • Female, 26Final Diagnosis: Post tonsillectomy secondary hemorrhageSymptoms: Bleeding • bleeding per oralMedication: —Clinical Procedure: Control of post tonsillectomy secondary hemorrhageSpecialty: OtolaryngologyObjective:Rare diseaseBackground:Post-tonsillectomy hemorrhage (PTH) has been reported in the literature as a serious complication after tonsillectomy that has high morbidity and can be life threatening. In cases of recurrent secondary PTH, one should consider coagulopathies as the hidden pathology. Factor XIII deficiency is very rare, suggested to be present 1 in 2 million people. Patients with undiagnosed factor XIII deficiency with secondary PTH are extremely rare.Case Report:We report on the cases of six patients (four adults and two children) who presented with recurrent attacks of secondary PTH.Conclusion:Recurrent, severe PTH could be related to undiagnosed hematological disorders.

Tumors involving the head and neck are uncommon in children. Furthermore, those which involve the external ear are extremely rare. In the external ear itself, the most commonly encountered malignancy is Squamous Cell Carcinoma, both in the adult and pediatric age groups. We encountered one such case of a 14 years old male with a recurring skin lesion involving the right external ear. In this report, we wish to highlight and address the difficulty in recognizing and managing such an unwonted pathology as Squamous Cell Carcinoma in the pediatric age group.