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Upon activation, Monsters still alive in the current room will be 're-rolled' and turned into another mob. All type of enemies from any floor (from Basement to Utero) may appear. The D10 can also re-roll enemies into Champions and vice-versa.
Does not re-roll bosses but can re-roll enemies bosses spawn, such as Death's scythes.
- On enemies that have extendable segments like Mr. Maw, the segments can be individually rerolled into enemies.