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I'll conceed that some high scores could be them 'breaking the game' but doing that on a challenge?
No idea if this is how it is supposed to work. Its too soon to know exactly what the new transformations do.
Tumors is apparently a transformation independent of Lilith. What you were observing with Dark Bum and Lil' Brimstone is Cambion Conception, where taking enough damage spawns a permanent familiar.
>DUHH ITS TEH DUNCE CAP
No, no it's not because I didn't pick it up.