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BMJ 1995; 311 doi: (Published 23 December 1995) Cite this as: BMJ 1995;311:1719

This 78 year old man presented with chest pain. He was given intramuscular diclofenac 75 mg by his general practitioner before admission. Electrocardiography confirmed anterior myocardial infarction, and intravenous streptokinase was given. Forty eight hours later he developed extensive bruising along the site of injection. Parenteral diclofenac should not be given in suspected myocardial infarction, and in other situations it should be given deep into the muscle.—J COX, registrar, E L C ONG, consultant physician, department of medicine, Newcastle General Hospital, Newcastle upon Tyne NE4 6 BE

Axial computerised tomography showed a large mass at the level of the tonsil, with displacement of the base of tongue and uvula of a 75 year old woman. She had attended her general practitioner for a routine examination before a trip abroad. Her doctor commented that she spoke as if she had a large plum in her mouth and this wasn't normal, even if she did come from the heart of the Cotswolds. At removal via a midline mandibulotomy approach with a covering tracheostomy, the lesion proved to be a benign pleomorphic salivary adenoma arising from a tonsillar fossa minor salivary gland. The resilient woman set off on holiday two …

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