Background Acute Fatty Liver of Pregnancy (AFLP) is a rare, catastrophic disease affecting women in the third trimester of pregnancy or in the post-partum period. It is usually a diagnosis of exclusion and requires a strong index of suspicion for a timely diagnosis and prompt intervention. Case presentation We report a case of AM, an 18 year patient, in her first pregnancy at 35 weeks gestation who presented with nausea, vomiting and jaundice. She had a vaginal delivery following spontaneous preterm labour. A clinical diagnosis of acute fatty liver of pregnancy was made on the 3rd day post-delivery. The post-delivery course was complicated by a deterioration of clinical symptoms with worsening hepatorenal function and development of encephalopathy. The patient died 3 days after admission and the diagnosis was confirmed on post-mortem and histology. Conclusion Delay in the diagnosis is associated with morbid complications with high mortality and this case highlights the importance of a high index of suspicion of the condition in women presenting with jaundice in pregnancy.

HighlightsMaffucci’s syndrome is a rare congenital musculoskeletal disorder.Life-long surveillance is mandatory for early detection of malignancies.Tubular adenoma of the breast is benign with an almost non-existent risk of malignant transformation.Benign breast tumours may cause ulceration of the skin leading to diagnostic confusion with malignancy.Giant tubular adenomas of the breast may be treated with lumpectomy even when the ratio of abnormal breast tissue to normal breast tissue is very high.