Metastatic tumours involving the nose and the paranasal sinuses are rare. Especially metastatic spread to the sphenoid sinus is an extremely rare occurrence. The most common metastatic tumour is the renal cell carcinoma. Only four cases of hepatocellular carcinoma presenting a sphenoid sinus metastasis could be found in a search of the literature. We report on the case of a 59-year-old male who suffered from a sphenoid sinus mass. A biopsy showed the tumour to be a metastatic hepatocellular carcinoma. The suspected primary tumour was then found in the left liver lobe. The early diagnosis of paranasal sinus malignancies is difficult because of the varied and nonspecific symptoms and signs. In cases of late diagnosis, the treatment is usually palliative with a poor prognosis. The importance of endoscopic examination and CT or MRI scan for early detection must be emphasized.