Snapshot quiz 11/11
Authors: Roberts JK, Guthrie AJ and Toogood GJ
The skin blisters and necrosis on the dorsum of the hands were diagnosed as porphyria cutanea tarda. The MRI demonstrates typical features of a hepatocellular carcinoma (HCC) (capsule, white arrow; areas of haemorrhage within the tumour, black arrows) arising within a non-cirrhotic liver (note the smooth contour, normal spleen size and lack of ascites). Cutaneous porphyria is the most common acquired porphyria, though an association with HCC is rare. Resection of the tumour was followed by regression of the skin lesions.