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We report the unusual concatenation of cecal carcinoma complicated by bacteremia and purulent pericarditis. The organism responsible for the pericarditis was not definitely established. The pericarditis was successfully managed by surgical drainage and antibiotic therapy. Colonic surgery followed eradication of the pericarditis.

A 62-year-old man had symptons of congestive heart failure precipitated by chronic blood-loss anemia. Barium-enema studies were consistent with diffuse polyposis of the colon. A total colectomy followed by ileoproctostomy was performed. Histologic examination of numerous polyps showed them to represent villous adenomas. Despite diffuse involvement, electrolyte depletion did not occur. Follow up is planned because of the possibility of future villous adenomas in the small bowel.

The case of a patient who had an unsuspected perforated adenocarcinoma of the appendix discovered during operation for a sigmoid carcinoma is presented. The problems in diagnosing carcinoma of the appendix are discussed and the literature is reviewed.

Hepatomegaly and abnormal liver function can occur in nonmetastatic malignancies. A patient with metastatic prostatic adenocarcinoma that had spared the liver and extrahepatic biliary tree is described. He had puzzling episodes of jaundice for a period of 2 1/2 years. The results of appropriate investigations and an exploratory laparotomy performed dlring the patient's four antemortem hospitalizations were indicative of "recurrent intrahepatic cholestasis," the cause of which remained an enigma even after exploratory laparotomy. At autopsy, no evidence of hepatic metastases or extrahepatic biliary obstruction was found. Alcohol, hepatotoxic drugs, toxins, viral and chronic active hepatitis, hemolysis, and extrahepatic biliary obstruction were eliminated as causes of the jaundice. We believe that the intermittent intrahepatic cholestasis is one of the nonmetastatic manifestations (nonmetastatic hepatopathy of malignancy) of the prostatic adenocarcinoma.