Porphyria cutanea tarda exacerbation as a paraneoplastic syndrome in vaginal cancer resolved with chemoradiation

Porphyria Cutanea Tarda (PCT) is a rare paraneoplastic syndrome. The effects of therapeutic ionizing radiation in patients with PCT are not well understood. We report the case of a 55 year-old woman with a past medical history significant for kidney transplant with rejection and removal on hemodialysis, Stevens-Johnson syndrome, porphyria cutanea tarda, undifferentiated connective tissue disease probably systemic lupus, and hepatitis C, who underwent curative chemoradiation treatment for a recurrent vaginal squamous cell carcinoma. There was no increased acute toxicity and active porphyria cutanea tarda improved over the course of radiation treatment and fully resolved within 1 year. However, there was significant myofibrotic late toxicity within the treated region.