Treatment Options for Faecolith (Stercoral) Obstruction of the Colon in Two Similar Cases.

A woman and man in their 20s presented to the accident and emergency (A&E) department with abdominal pain, vomiting, and absolute constipation. They both presented as atypical candidates for faecal impaction with few medical and lifestyle risk factors. On CT imaging, a faecolith was visualised in the sigmoid colon as a cause of the large bowel obstruction (LBO) in both patients. A faecolith obstruction can be a life-threatening sequela of faecal impaction. The first line of treatment for LBO is conservative management with oral laxatives and enemas. If this is unsuccessful, interventions such as flexible sigmoidoscopy with the placement of enemas above the blockage can be used. In the event of a compromise to bowel vascularity or if previous interventions prove unsuccessful, there is also scope for surgery. After the resolution of the blockage, follow-up investigations should be performed to elicit an underlying cause in the hope of preventing a recurrence.

Intracystic papillary carcinoma of breast: report of three cases and review of the literature.

Intracystic papillary carcinoma (IPC) of the breast is a rare malignant tumour, found mainly but not exclusively in elderly women. IPC may be asymptomatic or presents with a palpable mass or blood-stained nipple discharge. The tumour is encysted within a dilated duct with arborisation of the fibrovascular stroma and contains nodules of papillary carcinoma surrounded by a thick fibrous capsule. Frequently excisional biopsy is required for diagnosis. The mainstay of treatment is breast-conserving surgery or mastectomy. Sentinel node biopsy could be considered in invasive cases. Adjuvant radiotherapy (XRT) and/or endocrine therapy is considered in appropriate cases. Prognosis is excellent. We report three such cases of IPC, in elderly women, which were successfully treated.

Skin lesion in axilla: an unusual presentation of invasive lobular carcinoma of breast.

Invasive lobular carcinoma (ILC) of breast is known to present with atypical clinical findings in the breast, making it difficult to diagnose. It is also known to have unusual sites of metastases arising de novo or in patients treated for known ILC. Skin lesion in axilla could be a cutaneous metastasis from ILC or ILC in ectopic breast tissue (EBT). We present two cases with skin lesion in axillas which after excision were surprisingly reported as ILC. On further investigations these were found to be primary in EBT. Though such cases are reported, carcinoma arising from EBT is a very rare presentation and one should be aware of this, when dealing with a skin lesion.