PMC5548675_01
Skin examination showed multiple erythematous patches over his trunk, four limbs, scalp, and face.
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Moreover, gottron rash, and erythematous to violaceous raised papules overlying the metacarpals were noted (Fig. 1).
Contrast-enhanced abdominal computed tomography. A: A 5-cm sized hypervascular tumor on the right lobe of the liver (arrow). B: A small hypervascular nodule was also identified on the right lobe of the liver (arrow). C: The tumor invaded the main portal vein (arrow). D: The tumor invaded the bilateral portal veins (arrows).
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Contrast-enhanced abdominal computed tomography revealed cirrhosis with multiple hypervascular tumors of up to 5 cm in diameter on both lobes of the liver (Fig. 2A and B). Moreover, tumors invading the main portal vein and bilateral portal veins were also identified (Fig. 2C and D).
Motor conduction studies revealed the following abnormalities, which were consistent with inflammatory myopathy: prolonged distal latency with a reduced compound muscle action potential amplitude, a normal nerve conduction velocity and a delayed F response in the right peroneal nerve.
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A motor conduction study showed increased spontaneous activity with fibrillation, complex repetitive discharges, and positive sharp waves (Fig. 3).
The patient's clinical course with the clinical changes in liver and muscle enzymes.
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Two months later, the patient died due to the progression of his disease (Fig. 4).