Merkel cell tumor with liver metastases: presentation as fulminant hepatic failure

This report demonstrates that hepatic metastases can present with fulminant hepatic failure and that liver enzyme abnormalities may not become prominent until there has been massive replacement of the liver. The CT scan of liver may not demonstrate diffuse liver metastases as seen in this patient. Merkel cell tumor or trabecular neuroendocrine skin tumor is a previously unreported cause for the development of the syndrome of hepatic failure due to liver metastases.