HighlightsPrimary breast leiomyosarcoma is a rare disease with unclear diagnosis, management and prognosis.We present a case of primary breast leiomyosarcoma metastases to the lung in a young adult female.We provide a complete list and discussion of 68 documented cases of primary breast leiomyosarcoma.Treatment of breast leiomyosarcoma should include surveillance for lung metastases.

HighlightsSpontaneous common bile duct perforation is a rare clinical entity.Our case is the first case in the literature of a witnessed spontaneous common bile duct perforation.Our patient was diagnosed prior to surgical intervention, which is unusual with this disease process.

Ectopic pregnancy is a life-threatening condition affecting up to 2% of gestations. Implantation in the fallopian tube is most common, with symptoms typically presenting earlier for gestations in the ampulla and isthmus compared with the cornua and non-tubal sites. In this paper, the cases are described of two patients with advanced ectopic pregnancies that ruptured. One woman aged 36 years presented at 17 1/7 weeks' gestation with a ruptured cornual ectopic pregnancy. The other woman, aged 35 years, presented at 11 1/7′ weeks gestation with a ruptured ectopic pregnancy in the left tubal ampulla. To our knowledge, there are no other reported cases of a tubal ampulla pregnancy presenting at such an advanced gestation with no prior symptoms.

Background: Acts of violence can be considered random when viewed singularly, but are appreciable as patterns and clusters of an epidemic. Violence begets violence: it has been shown that people exposed to violence are more likely to harm themselves, their families, and members of the community. Our previous manuscript on this subject demonstrated distinct clusters of violent trauma, where each subtype appeared to have its own domain. Methods: The location, date, time of day, and mechanism of injury of all non-accidental trauma patients from 1 January 2008 to 31 December 2013 were collected and analyzed. Kernel density analysis was used to identify areas of increased activity and these were compared by year. The areas identified were mapped by their latitude and longitude. The data for the year 2013 were used to determine the potential for the predictive value of the prior 5 years. Results: Definite trends can be observed in the temporal distribution of trauma, with a higher incidence of violent trauma occurring between 6 pm and 6 am during the 6-year period. Seasonal variation of higher amounts of violent trauma is also observed from April through August. Predictive modeling did not yield significant results for the following year or for the following month using Crimestat software. Conclusion: Discernable trends of trauma are able to be demonstrated based upon the identifiable clusters of assault but these clusters do not remain constant from year to year. Predictive modeling can assist with the identification of elevated incidents of activity, however has poor predictive value for the entirety of the year. The use of the Crimestat Time Series Forecasting Module is best served with the early indication of large changes in assault patterns. Further study and improved collaboration with the local police precincts and surrounding trauma centers is required to treat the epidemic of violence.