Adenomatous polyp--cause of postmenopausal bleeding in a breast cancer patient treated with tamoxifen

We present a case of adenomatous polyp with degenerative changes causing abnormal postmenopausal bleeding in a patient who was treated with adjuvant therapy of Tamoxifen for breast cancer after surgery (Modified Radical Mastectomy). The association with prolonged unopposed estrogen--like stimulation with Tamoxifen as a possible factor in this development has been discussed. Until further cases are reported, it would seem imperative to advise all women who are to be treated with Tamoxifen for breast malignancy to have a pelvic examination before such treatment with strict follow up at regular intervals later on. Abnormal bleeding may also be the result of Tamoxifen stimulation and endometrial biopsy may be necessary in these patients should abnormal bleeding occur. Surgical exploration for enlarging leiomyomas or abnormal bleeding will still be necessary to ensure that malignancy is not present, but the pre-operative diagnosis will be less alarming.

Ileo-ileo-colic intussusception secondary to an ileal lipoma.

Adult intussusception is extremely uncommon and constitutes approximately 5-16% of all intussusceptions. We describe a case of ileo-ileo-colic intussusception secondary to an ileal lipoma occurring in a 22 year old man who in addition had autosomal dominant polycystic kidney disease. CT scan played a pivotal role in not only demonstrating the cause of intestinal obstruction (intussusception) but also showed that a lipoma was the lead point precipitating the intussusception.

Primary linitis plastica of the rectosigmoid in a thirteen year old boy.

Childhood malignant neoplasms of the gut are extremely rare. The reported incidence of colorectal cancers in patients under 20 years of age is 1 in 10 million. The low index of suspicion for this tumour in children results in advanced disease at diagnosis and subsequently a poor prognosis. A rare case of a primary linitis plastica of the rectum occurring in a 13 year old boy is reported with review of pertinent literature.