You are correct. Angiofibromas are small, skin-colored to yellow-red, translucent papules located symmetrically over the forehead, nose, and cheeks. They are associated with tuberous sclerosis, an autosomal dominant condition. The classic triad of epilepsy, learning difficulties, and angiofibromas occurs only in a small minority of cases, however. Lesions may be misdiagnosed as acne vulgaris, but do not respond to acne therapy. They can be treated for cosmesis with shave excision, dermabrasion, or laser tx; recurrence is common.

You are correct. The patient excreted a necrotic, full-thickness colonic cast. Histologic exam revealed all layers of the bowel wall. Passage of a colonic cast as a result of colonic hypoperfusion is rare and is characterized by the absence of peritonitis. In this patient, colonoscopy revealed a stricture with ischemic-appearing granular mucosa. She was initially treated conservatively, but ultimately underwent resection of the necrotic portion of the left-sided colon with definitive colostomy; she eventually recovered fully.