Facial cutaneous metastasis from carcinoma is a rare and late clinical finding that is associated with disseminated disease and a poor prognosis. Skin metastases predominantly originate from primary tumours of the lung and melanoma. Skin metastases from colon tumours occur in only 4-6.5% of cases of metastatic colorectal cancer. They are most often located on the abdominal skin. We present an unusual case in which a primary colorectal adenocarcinoma metastasised to the face. This cutaneous lesion occurred 4 years after diagnosis of the primary tumour. This case highlights the importance of prompt investigation of new or evolving skin lesions in patients with a history of malignancy. Early detection and initiation of treatment may prevent development of widespread skin metastases and extend life expectancy.

A De Garengeot hernia is a rare and interesting presentation of a groin lump, with the diagnosis usually only being identified during surgery. It still presents clinicians with diagnostic and therapeutic challenges, owing to the lack of signs associated with sepsis and so an important case to highlight. We present a case report of a 90-year-old woman who developed a De Garengeot hernia as part of her presentation of bowel obstruction illustrating the importance of careful examination and to ensure prompt diagnosis and initiation of appropriate multidisciplinary management.

Lemierre's syndrome is a rare yet potentially fatal cause of sore throat. Recently published literature suggests an increase in the incidence of this 'forgotten disease', highlighting Lemierre's syndrome as a clinically important differential diagnosis of sore throat. We present a case report of an 85-year-old man who developed a sore throat, which illustrates the re-emergence of Lemierre's syndrome. Reducing the morbidity and mortality from this disease requires a high index of clinical suspicion to ensure prompt diagnosis and initiation of appropriate multidisciplinary management.

Purtscher's retinopathy is a haemorrhagic and vaso-occlusive retinal vasculopathy, caused by microembolisation occluding retinal and choroidal arterioles. This leads to retinal haemorrhages and ischaemia. The usual cause is severe trauma. 1 However, a variety of conditions including acute pancreatitis, childbirth, long bone fracture, chest trauma and systemic inflammatory vasculitides may cause similar retinal presentations. 1–4 This highlights Purtscher's retinopathy as a clinically important differential diagnosis of visual loss. We present a case report of a 43-year-old man who was diagnosed with acute pancreatitis. While in hospital he developed sudden onset unilateral loss of vision. This case highlights the need to ensure prompt diagnosis and initiation of appropriate multidisciplinary management.