Intravenous leiomyomatosis (IVL) is extremely rare with just around 300 cases reported in literature. 1 With its unusual growth pattern and clinically aggressive behavior, this benign tumor can masquerade as a malignancy and present a diagnostic challenge. Concurrent uterine fibroids or recent hysterectomy for the same often provides a hint towards the diagnosis. 2 The median interval between hysterectomy and diagnosis of IVL is approximately 4 years. 3 We present a case of IVL detected 10-years post total hysterectomy, bilateral salpingo-oophorectomy (THBSO) and parametriectomy with emphasis on multimodality imaging with multip
Leiomyomatosis

Objective: To evaluate the performance of contrastenhanced ultrasound (CEUS) in the risk stratification of indeterminate renal lesions picked up incidentally on abdominal imaging, in patients with renal impairment. Methods: A retrospective study was performed of nonconsecutive patients who underwent CEUS at our tertiary care centre for indeterminate renal lesions between March 2010 and September 2014. A total of 63 patients with 74 nodules were assessed with CEUS and stratified into either benign (Bosniak I, II, IIF) or suspicious for malignancy (Bosniak III, IV or hypervascular solid lesions). Diagnostic accuracy was determined by comparing these findings to subsequent histological diagnoses, temporal change after at least 20 months follow-up or after a diagnostic computer tomography / magnetic resonance imaging study. Results: CEUS correctly identified 49/52 (94.2%) of benign lesions and 21/22 (95.5%) of malignant lesions, resulting in a sensitivity of 95.5% (95% CI 77.2-99.9%), specificity of 94.2% (95% CI 84.1-98.8%), positive predictive value (PPV) 87.5% (95% CI 67.6-97.3) and negative predictive value (NPV) 98.0% (95% CI 89.4-100%). Conclusion: CEUS has high diagnostic performance in predicting the benignity of a renal lesion in patients with renal impairment, showing sensitivity and NPV approaching 100%.
Carcinoma, Renal Cell

Female ; Hearing Loss, Noise-Induced ; diagnosis ; Humans ; Leisure Activities ; Male ; Music ; Noise ; adverse effects

INTRODUCTIONNoise-induced hearing loss (NIHL) is a preventable condition, and much has been done to protect workers from it. However, thus far, little attention has been given to leisure NIHL. The purpose of this study is to determine the possible music listening preferences and habits among young people in Singapore that may put them at risk of developing leisure NIHL.

METHODSIn our study, the proportion of participants exposed to > 85 dBA for eight hours a day (time-weighted average) was calculated by taking into account the daily number of hours spent listening to music and by determining the average sound pressure level at which music was listened to.

RESULTSA total of 1,928 students were recruited from Temasek Polytechnic, Singapore. Of which, 16.4% of participants listened to portable music players with a time-weighted average of > 85 dBA for 8 hours. On average, we found that male students were more likely to listen to music at louder volumes than female students (p < 0.001). We also found that the Malay students in our study listened to louder music than the Chinese students (p < 0.001).

CONCLUSIONWe found that up to one in six young persons in Singapore is at risk of developing leisure NIHL from music delivered via earphones. As additional risks due to exposure to leisure noise from other sources was not taken into account, the extent of the problem of leisure NIHL may be even greater. There is a compelling need for an effective leisure noise prevention program among young people in Singapore.

Adolescent ; Audiometry ; Female ; Habits ; Hearing Loss, Noise-Induced ; diagnosis ; Humans ; Leisure Activities ; MP3-Player ; Male ; Music ; Noise ; adverse effects ; Risk ; Singapore ; Students ; Young Adult

INTRODUCTION: Melanomas in Asians have different clinicopathological characteristics and prognosis from melanomas in Caucasians. This study reviewed the epidemiology and treatment outcomes of cutaneous melanoma diagnosed at a tertiary referral dermatology centre in Singapore, which has a multiracial population. The study also determined whether Asians had comparable relapse-free and overall survival periods to Caucasians in Singapore. METHOD: This is a retrospective review of cutaneous melanoma cases in our centre between 1996 and 2015. RESULTS: Sixty-two cases of melanoma were diagnosed in 61 patients: 72.6% occurred in Chinese, 19.4% in Caucasians and 3.2% in Indians, with an over-representation of Caucasians. Superficial spreading melanoma, acral lentiginous melanoma and nodular melanoma comprised 37.1%, 35.5% and 22.6% of the cases, respectively. The median time interval to diagnosis was longer in Asians than Caucasians; median Breslow's thickness in Asians were significantly thicker than in Caucasians (2.6mm versus 0.9mm, CONCLUSION More physician and patient education on skin cancer awareness is needed in our Asian-predominant population for better outcomes.
Humans ; Melanoma/therapy* ; Prognosis ; Retrospective Studies ; Singapore/epidemiology* ; Skin Neoplasms/therapy* ; Treatment Outcome