Peutz-Jeghers syndrome is an uncommon genetic defect in the signal pathways of growth. The incidence has most recently been estimated to be in the range of 1 per 120,000 live births [1]. It is characterized by hamartomas throughout the gastrointestinal tract, mucocutaneous melanotic spots and increased predisposition to malignancy. The infrequent presentation of this syndrome in most practice combined with some less well-known diagnostic features may contribute to a misdiagnosis. Further, understanding of the genetic defect leading to the phenotypic syndrome and the future implications of this defect continue to evolve. Therefore we present a review in the setting of a case of misdiagnosed Peutz-Jeghers syndrome to portray illuminating features of the syndrome and review the literature.

State courts have produced three major exceptions to the employment at‐will doctrine: (1) violation of public policy, (2) breach of an implied contract (including written policies, oral promises, and implied covenants of good faith and fair dealing), and (3) commitment of a tort of emotional distress, defamation, or third‐party interference with a contractual relationship. We analyzed state appellate court decisions to identify judicial philosophies and to determine which states have accepted or rejected the various exceptions to employment at‐will. Our results show that the states vary considerably. The most commonly accepted arguments against employment at‐will are violations of public policy, breaches of implied contracts in employee handbooks, and torts of outrageous emotional distress. Overall, this research highlights the need for statewide consistency with regard to the at‐will issue.

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