No abstract

SUMMARY The incidence of malignant melanoma in developed countries has been rising rapidly in recent years. Its causes and the reasons for this trend are uncertain. Changes in histopathological criteria for classifying pigmented skin lesions could explain the rising incidence rates. With support from the International Agency for Research on Cancer, this hypothesis is explored but not substantiated for time trends in the South Western Region, United Kingdom.

We report a case of delayed perforation of normal colonic wall by the wire tips of an enteral Wallstent, which had successfully been used to treat a malignant obstruction of the sigmoid colon. Perforation occurred 5 days following insertion and despite surgery, resulted in fatality. Though perforation at the tumor site is a recognized complication during or following colonic stent placement, it is rare for the ends of the stent to perforate through nondiseased bowel wall. The site of the obstructing lesion and thus the position of the stent on a bend in the colon may be a contributory factor.

An 81 year old man presented with an asymptomatic swelling of his left upper limb. The patient's past medical history included angina, hypertension, and a stroke (five years previously) which left him with mild dysphasia, but no other deficit. There was no past medical or family history of thrombosis. There was a two day history of swelling. The arm was not painful, hot or red, and there was no history of trauma. Apart from pain in the left side of his neck, which had been present for three weeks, the patient was well. System King's Mill Centre,