Dear Editor, Erdheim-Chester disease (ECD) is a rare non-Langerhans histiocytosis, usually affecting middle-aged to older adults. It is a multisystemic disease with protean clinical manifestations. It can involve single or multiple organs, and presentations range from asymptomatic lesions detected incidentally on imaging to severe organ dysfunction. Hence, accurate and timely...

INTRODUCTION In March 2022, the European Commission on cancer screening suggested the inclusion of low-dose computerised tomography (LDCT) for lung cancer, targeted at current and former smokers.1 The aim of LDCT screening is to increase early detection, decrease diagnoses at metastatic stage of the disease and improve overall 5-year...

An 81-year-old woman of healthy weight presented with a 2-week history of a painless right axillary lump. Physical examination revealed a 2cm firm nodule with a central keratinous plug in the right axilla (Fig. 1). The surrounding skin was pigmented, non-tender and indurated. Sonography of the nodule demonstrated an...

Dear Editor, Magnetic resonance imaging (MRI) contrast media are commonly used in medical imaging and are usually gadolinium-based contrast agents (GBCAs). They can be divided into 3 groups. Group I consists of compounds with linear molecular structures. Group II consists of compounds with macrocyclic molecular structures. Group III currently includes...

New computed radiography imaging systems are slowly gaining a foothold in radiological departments worldwide. By computed radiography we mean a digital imaging system which exposes a photostimulable phosphor image receptor plate to obtain a latent image using existing radiographic equipment. This article is available only as a PDF. Please click...

Nasopharyngeal carcinoma (NPC) is an aggressive infiltrative neoplasm. Spread into the paranasal sinuses is often seen but the frequency is documented in only a few series. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

This book is a collection of 30 case studies, which were published in the Singapore Medical Journal from 1994 to 1997. They include interesting cases from all the major anatomical regions and organ systems. This article is available only as a PDF. Please click on “Download PDF” on top to...

Our patient was a 39-year-old Chinese man with nasopharyngeal carcinoma (NPC) presenting initially with right upper cervical lymphadenopathy. He was treated primarily with a course of radiotherapy, following which he was examined three monthly and was found to be free of disease in the nasopharynx and the neck. This article...

Osteoporosis is well documented to be a significant determinant of the risk of fracture and its assessment in vivo has been based on various methods for measuring bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) has proven so far to be reasonably precise (about 1% to 2%) and accurate...

Ingested foreign bodies are a common condition in the practice of Otolaryngology. In particular, there is no doubt a greater tendency in the local community to consume fish without it being de-boned. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

In the evaluation of chronic shoulder pain and dysfunction clinically suspected to be due to shoulder impingement syndrome and rotator cuff tendon tears, magnetic resonance imaging (MRI) has virtually replaced double contrast shoulder arthrography. MRI has the advantage of demonstrating the shoulder joint in multiple anatomical planes with excellent...

Although otitis externa is a common otological condition, the literature pertaining to it is sparse in contrast to the vast amounts of articles that have been published on otitis media. Indeed, the exact pathogens involved in the local community have not been documented. This article is available only as a...

In most institutions, about 10% to 25% of imaging examinations are recorded digitally (e.g. digital subtraction angiography, computed tomography, magnetic resonance imaging and ultrasound). Conventional-projection radiographic studies are still displayed in an analog fashion (on film). This article is available only as a PDF. Please click on “Download PDF” on...

Liver abscess traditionally has been treated by open surgical drainage, mortality rates being as high as 80% to 100% if left untreated. However, with the advent of modern non-invasive imaging techniques, percutaneous techniques performed under imaging guidance have, over the recent years, become increasingly acceptable as a suitable alternative...

Systemic sclerosis (SScl) is a generalised disease of the connective tissue characterised by fibrosis and vascular changes affecting the skin, lungs, gastrointestinal tract, kidneys, and heart. The American College of Rheumatology has proposed that for the purpose of clinical trials and surveys, the diagnosis is made if the patient...

Since the discovery of X-rays over a century ago, radiology has played a pivotal role in rheumatology and diseases of the joints. The innovations and advances in technology in imaging and interventional radiology today enable more precise and earlier detection, assessment and treatment. This article is available only as a...

Accurate detection of brain metastases is an important part of tumour staging. Magnetic resonance (MR) imaging is well accepted as a sensitive tool in the detection of brain metastases. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

For a number of years, transantral orbital decompression formed the mainstay of surgical treatment of thyroid-related orbitopathy. The goal of this and several subsequently-described operations was to increase orbital volume at the selective expense of the bony orbital walls and, often, the adjacent paranasal sinuses. This article is available only...

Long-term central venous access is an important part of modern medical practice, especially in the haematology and oncology units. Central venous (CV) catheters are used for the administration of anti-neoplastic agents, immunosuppressive drugs, antibiotics, blood components, hyperalimentation, for frequent blood sampling, and for acute and temporary haemodialysis prior to...

The understanding of blood supply is the cornerstone of successful tissue transfer in reconstructive surgery. This understanding has been derived largely from cadaveric dissections, combined with injections to outline the blood supply. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Osteoarthritis is a common joint disease that involves destruction of articular cartilage. Magnetic resonance imaging (MRI) provides a sensitive imaging modality for the diagnosis of osteoarthritis. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Castleman’s disease (CD) was first proposed by Castleman in 1954. It is usually found in the mediastinum, but other sites have been described. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

A 53-year-old man with a history of hypertension and asymptomatic Wolff-Parkinson-White syndrome was admitted to the hospital for an elective uvulopalatopharyngoplasty, tonsillectomy and bilateral functional endoscopic sinus surgery for mild obstructive sleep apnoea and chronic sinusitis respectively. He weighed 109 kg, all his four upper incisors were missing and...

A 16-year-old boy, with a background history of beta-thalassaemia intermedia, splenectomy and hypogonadotrophic hypogonadism, was referred to our otolaryngological clinic for right otalgia following an episode of upper respiratory tract infection (URTI). He had hearing loss with tinnitus in the right ear, nasal obstruction with greenish nasal discharge and...

Over the past 10 years we have used various radiopharmaceuticals (RPCs) for imaging of inflammation and infection. These include gallium-67 citrate and the technetium-99m labelled nanocolloids, immunoglobulin (IgG), antigranulocyte antibodies (AGAB) and HMPAO-labelled leukocytes. This article is available only as a PDF. Please click on “Download PDF” on top to...

Laryngectomised patients have been shown to have significant physical and psychosocial problems. These relate not only to respiratory symptoms but also psychological symptoms such as sleep disturbance, fatigue, social isolation and distress. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Shoulder instability is a frequently encountered clinical problem in young active people following injury, particularly in athletes. The labral-ligamentous complex is increasingly recognised as being an important structural component that contributes to shoulder instability. This article is available only as a PDF. Please click on “Download PDF” on top to...

Worldwide, in the past decade, the application of magnetic resonance imaging (MRI) has increased tremendously in the management of musculoskeletal trauma. Not least is its application as a valuable diagnostic tool in occult hip fracture evaluation. This article is available only as a PDF. Please click on “Download PDF” on...

Obstructive sleep apnoea (OSA) is characterised by a cessation of normal oronasal airflow for 10 seconds or longer, and repetitive closure of the upper airway during sleep, resulting in sleep fragmentation and daytime hypersomnolence. Snoring and OSA in adults are more common with increasing age, in the obese and...

Thyroglossal duct cysts are the most common nonodontogenic cysts that occur in the neck. They can be complicated by infections and fistulae. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Differentiated thyroid carcinoma (DTC) is not an uncommon tumour in Thailand.1 A high percentage of 10-year survival results in long-term follow-up. I-131 total-body scan (I-131 TBS) is commonly used for monitoring the disease after surgery and radioiodine ablation in most centres. This article is available only as a PDF. Please...

The solitary thyroid nodule is a common clinical finding in the Otolaryngology practice. Although most lesions are ultimately shown to be benign, the management of the patient with a thyroid nodule remains a clinical challenge because of the 5% to 10% risk of malignancy. This article is available only as...

A 40-year-old Chinese male presented with severe right loin pain. He had a history of chronic abdominal aortic dissection of unknown aetiology. He was not hypertensive and there was no evidence of ankylosing spondylitis, Ehlers-Danlos syndrome or any connective tissue disorder. This article is available only as a PDF. Please...

Percutaneous nephrostomy (PCN) is a well-established technique in the armamentarium of an interventional radiologist when dealing with urinary obstruction. It provides temporary relief in obstructive uropathy and stabilises the patients for subsequent definitive treatment. This article is available only as a PDF. Please click on “Download PDF” on top to...

Bone mineral densitometry was developed as a means to quantify the bone mineral content of the skeleton accurately and has been used in the diagnosis of osteopenia and osteoporosis. Dual-energy X-ray absorptiometry (DXA) of the axial skeleton is one such technique2 which is based on a subtraction method. This article...

With the general increase in life expectancy in the local population, the incidence of osteoporosis is anticipated to rise as well. Even with screening modalities such as bone mineral densitometry and preventive treatment such as hormone replacement therapy, many patients are asymptomatic and are diagnosed with osteoporosis only after...

An elderly patient presenting with backache and vertebral collapse on plain X-ray is a common clinical scenario and a diagnostic challenge. It is difficult to differentiate between benign and malignant causes for the vertebral collapse. This article is available only as a PDF. Please click on “Download PDF” on top...

It was the late Dr BM Johns, a general surgeon, a New Zealander and Head of Surgical Unit “B” Singapore General Hospital (SGH), who first practised simple Ear, Nose and Throat in addition to his general surgical practice after World War II (1941-1945). After his internment as a prisoner...

We would like to draw the attention of your readers to the comments made in the editorial of the recent Imaging issue of your journal. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Biopsy may be performed at surgery (open biopsy) or percutaneously (closed biopsy). Percutaneous bone biopsies are usually performed under imaging guidance using a variety of modalities, such as fluoroscopy1 and computed tomography (CT), and less commonly, ultrasonography (US) and magnetic resonance (MR) imaging. This article is available only as a...

In females with cancer, cervical carcinoma is second to breast cancer in both incidence and mortality worldwide. About 465,000 new cases are diagnosed each year in both developing and industrialised nations, with a higher incidence in women of low socioeconomic status. This article is available only as a PDF. Please...

Schwannomas are extra-axial neoplasms derived from the nerve sheath of peripheral or cranial nerves. They represent approximately 8% of all intracranial tumours, arising predominantly from the vestibular nerve. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Severe acute respiratory syndrome (SARS) is an atypical pneumonia that was first reported in early 2003. Reports of outbreaks of cases rapidly appeared in Hong Kong, Vietnam, China and Singapore. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Magnetic resonance cholangiopancreatography (MRCP) has attracted a lot of interest from clinicians because it is a non-invasive method of obtaining a cholangiographic image without the morbidity that is associated with endoscopic retrograde cholangiopancreatography (ERCP). This article is available only as a PDF. Please click on “Download PDF” on top to...

A review of mediastinal masses in children, emphasising imaging features, is important for several reasons. Firstly, the mediastinum is the most common location for thoracic masses in children. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Like other radionuclide techniques, positron emission tomography (PET) is based on the tracer principle – a small amount of labelled ligand is used to trace the metabolic pathway of an important chemical in the cell. PET complements anatomic imaging by its ability to map function or metabolism. This article is...

Prostate cancer is usually suspected due to an abnormal digital rectal examination, elevated serum prostate specific antigen (PSA) level or both. The diagnosis of prostate cancer depends on histopathologic examination of tissue obtained from systematic sextant core needle biopsy under transrectal ultrasound guidance. This article is available only as a...

When a child or young adult with morphologically normal external ears and no previous history of ear discharge or trauma presents with conductive hearing deficit, a congenital middle ear anomaly should be sought. Although fenestral otosclerosis is a differential diagnosis, the early onset of symptoms and a lack of...

The introduction of a new diagnostic test into a clinical arena goes through a number of stages. The first stage is technical development. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The pandemic of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a global healthcare problem and HIV infection is the most common cause of death worldwide. There are now 60 million deaths recorded from the infection worldwide by the United Nations AIDS (UNAIDS) organisation, most of them in sub-Saharan...

In January 2002, the first population-based national mammographic breast screening programme in Asia, the Singapore National Breast Screening Programme (BreastScreen Singapore), was launched. The programme aims to achieve international standards of breast screening practice and breast cancer detection, as well as to reduce or stabilise the mortality from breast...

A large majority of superior vena cava (SVC) syndrome is caused by malignancy (74% to 95%). This can either be due to direct SVC invasion or secondary to extrinsic compression. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Nasopharyngeal carcinoma (NPC) is an epithelial malignancy occurring worldwide with particularly high frequencies in the Far East. The incidence is highest in Hong Kong followed by Singaporean Chinese. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

T2-weighted magnetic resonance (MR) imaging is an important sequence for characterisation of focal liver lesion. Accurate characterisation of benign lesions, such as haemangioma or cyst, is important to prevent unnecessary procedure or surgery. This article is available only as a PDF. Please click on “Download PDF” on top to view...

Diffusion-weighted magnetic resonance (MR) imaging (DWMRI) is becoming essential to the assessment of acute cerebral infarction and has also been applied to distinguish cerebral abscess from necrotic intracranial neoplasm. There have also been a few case reports on DWMRI of encephalitis. This article is available only as a PDF. Please...

Candidates for cochlear implantation undergo a thorough audiological and medical assessment. The audiological assessment is done to ensure that these candidates who have bilateral profound or severe hearing loss have been given adequate hearing amplification, but show no significant benefit. This article is available only as a PDF. Please click...

Double reading of mammogram is not the standard practice in the United Kingdom National Health Service Breast Screening Programme (NHSBSP). Rather, single reading of the mammogram remains the basic policy, as was recommended in the Forrest report. This article is available only as a PDF. Please click on “Download PDF”...

The incidence of breast cancer peaks between the ages of 45 and 55 years. Approximately 7% of breast cancers occur below 40 years of age. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

It has been 10 years since the first ever issue of Annals dedicated to “Radiology” was published in Volume 22 No. 5 September 1993. Keeping in mind the tremendous growth in the development and applications of Imaging for both Diagnosis and Intervention, this second theme issue is long overdue. This...

Colorectal cancer is the second most common cancer in Singapore, accounting for 15.9% of all cancers registered with the Singapore Cancer Registry in the years between 1993 and 1997. Despite recent advances in surgery, radiotherapy and chemotherapy, more than half of those afflicted will die from their cancer. This article...

It is important to recognise the computed tomography (CT) appearance of hepatic metastases from colorectal primaries, as resection in a selected group may offer a 20% to 40% rate of five-year survival compared to 5% to 10% with non-surgical management. This article is available only as a PDF. Please click...

Colorectal cancer is a common primary that metastasizes to the liver. About 20% of patients with colorectal cancer will have detectable metastases at the time of clinical presentation, with an additional 30% developing clinical evidence of hepatic disease within 24 months. This article is available only as a PDF. Please...

Since its introduction into clinical practice in the early 1970s, ultrasound (US) has become firmly established as an extremely valuable imaging modality and widely used to the extent that abdominal US is the second most commonly performed imaging study (after chest radiography). Our department has also experienced a steady...

Insulinomas are small tumours with dimensions that seldom exceed 2.0 cm in diameter. Preoperative non-invasive localisation using trans-abdominal ultrasound and conventional computed tomography (CT) detect only between 25% and 60% of insulinomas. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Before I commence, I would like to thank the Singapore Radiological Society and the Chapter of Radiologists of the Academy of Medicine for inviting me to speak today on the occasion of the inauguration of the FY Khoo Lectureship. I was initially hesitant. This article is available only as a...

Isolated infection of the sphenoid sinus is uncommon. It usually occurs in conjunction with infection of the other paranasal sinuses. Acute isolated sphenoid sinusitis is seen in fewer than 3% of all cases of sinusitis. This article is available only as a PDF. Please click on “Download PDF” on top...

Pyriform sinus fistula is a developmental abnormality of the 3rd or 4th branchial pouch. It usually presents in childhood as acute inflammatory swelling of the neck and frequently involves the thyroid gland. This article is available only as a PDF. Please click on “Download PDF” on top to view the...

Catheter angiography has long been considered the diagnostic standard by which the accuracy of other vascular imaging modalities are compared, given its superior contrast and spatial resolution, as well its high selectivity and ability to show the full extent of vascular disease, presence of contralateral disease, patterns of collateral...

Mammography is the modality of choice to screen for breast cancer in asymptomatic women. However, it is known that about 10% to 12% of breast cancers are mammographically occult. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Coronary artery disease (CAD) is a major health problem worldwide. With advances in CAD intervention and improvements in treatment and management of CAD, there has been a dramatic increase in the survival rate of patients. This article is available only as a PDF. Please click on “Download PDF” on top...

Septic ovarian venous thrombosis is an uncommon entity. Classically, it occurs as a postpartum complication with reported frequency of 1 in 600 to 2000 deliveries. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The purpose of these guidelines is to provide a broad framework for clinicians considering the use of positron emission tomography (PET) scanning for their patients. PET imaging is a rapidly evolving field, with ongoing developments in imaging technology, radiochemistry, isotope production, animal research and clinical applications. This article is available...

Positron emission tomography (PET) has a proven clinical role in oncology, cardiology and neurology that primarily uses 2-deoxy-2--fluoro-deoxyglucose (FDG). FDG is an analogue of glucose that mimics the cellular uptake and initial metabolism of glucose, which enables cells utilising excess glucose to be visualised. Increased glucose metabolism is commonly...

Ischaemic heart disease associated with depressed left ventricular function is a common clinical management dilemma. There is overwhelming evidence that such patients have a poor prognosis when treated medically. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Carcinoma of the lung is the leading cause of cancer death in both men and women and is the second most common malignancy in both men and women. In 2003, it is estimated that there will be 171,900 new cases of lung carcinoma diagnosed in the United States and...

Positron emission tomography (PET) is distinct from other imaging modalities in its ability to probe the physiology and biochemistry of normal and abnormal tissues. It is based on the same principle of tracer kinetics used in conventional nuclear medicine. This article is available only as a PDF. Please click on...

Positron emission tomography (PET) has become a powerful scientific and clinical tool for probing biochemical processes in the human body. This is due, in large part, to advances in instrumentation and synthetic chemistry. This article is available only as a PDF. Please click on “Download PDF” on top to view...

The past few years have seen the transition of positron emission tomography (PET) from the research domain into mainstream clinical applications for oncology. The emergence of PET as the functional imaging modality of choice for diagnosis, staging, therapy monitoring and assessment of recurrence in cancer has led to an...

Contemporary medical imaging is progressing towards quantification of tissue function in addition to merely providing anatomical information, as illustrated by the rising use of such modalities as functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS) and positron emission tomography (PET). As far back as 1951, positron-emitting radiotracers have...

The diagnosis of pulmonary embolism (PE) can be a challenging problem. It depends on clinical suspicion and the interpretation of a combination of clinical and radiological presentations. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Radiofrequency (RF) ablation for the treatment of focal liver malignancies is a relatively new image-guided procedure that is gaining increasing acceptance in the radiologic and surgical community, particularly as an alternative treatment option for patients who have inoperable tumours. The potential benefits of minimally invasive image-guided ablation, as compared...

Publicity about new developments in medical technology is not at all unusual. But the degree with which multi-slice computed tomography (MSCT) for coronary artery disease (CAD) detection has captured the imagination of the public appears exceptional. This article is available only as a PDF. Please click on “Download PDF” on...

Radiology is undergoing unprecedented changes. Not only is the technology evolving rapidly, providing images of breathtaking anatomical clarity, but functional information has also become a reality. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Radiological images are critical for diagnosis, teaching and research. In radiology education, learners must be exposed to large amounts of visual information, and assimilation of these medical images is essential in the training of diagnostic skills. This article is available only as a PDF. Please click on “Download PDF” on...

Teleradiology is the electronic transmission of radiologic images from one location to another for the purposes of interpretation and/or consultation. The current interest in teleradiology is fuelled mainly by rapid technological advances, a worldwide shortage of radiologists, and cost considerations in developed countries. This article is available only as a...

Severe acute respiratory syndrome (SARS) is a newly emerged atypical pneumonia caused by the SARS-associated coronavirus (SARS-CoV). It is easily transmitted via droplet infection from close contact. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The histopathology of salivary gland tumours is extremely varied and complex. Amongst the epithelial neoplasms alone, at least 9 different adenomas and 17 different carcinomas are recognised. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Schwannoma or neurilemmoma (NL) is a well-defined, usually benign, tumour arising from the nerve sheath (Schwann cell). It may present as a solitary mass in any part of the body, but is more commonly seen in the head and neck, the extremities and on the trunk. This article is available...

A 52-year-old female was diagnosed with well-differentiated adenocarcinoma of the sigmoid colon in 1999. An anterior resection was performed followed by adjuvant chemotherapy for 6 cycles. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The use of vestibular exercises to treat patients with persistent symptoms of positional vertigo and disequilibrium has been around for many years. The Cawthorne and Cooksey exercises, developed in the 1940s, consist of a series of eye, head and body movements aimed at treating patients with unilateral vestibular paresis...

Sports-related knee injuries are common, with contact sports and sports involving twisting movements being the most frequent causes. Sports injuries may affect any of the knee structures, including ligaments, menisci, bones, cartilage and periarticular soft tissues. This article is available only as a PDF. Please click on “Download PDF” on...

Prostate cancer ranks among the top 10 cancers in Singapore. The incidence of prostate cancer has risen by 5% to 118% in most Asian countries. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier’s disease, is a non-inflammatory enthesopathy of unknown etiology. Affecting predominantly men, it results in flowing, robust ossification of the anterior longitudinal ligament of the spine. This article is available only as a PDF. Please click on “Download PDF” on top to...

A 71-year-old female developed several episodes of intermittent bleeding from the mouth with an underlying history of foreign body sensation in the throat for many years. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Double contrast barium enema (DCBE) is a safe and accurate diagnostic procedure for colorectal cancer. It is often the next diagnostic test after incomplete colonoscopy, with an additional diagnostic yield of 3.2% for neoplastic lesions larger than 1 cm in the non-visualised portion of the colon. This article is available...

Bezoars and gallstones are unusual causes of small bowel obstruction, with well-described imaging features on CT. We present a case of intestinal obstruction caused by a laminated mass in the terminal ileum that resembled a gallstone on CT, but was surgically proven to be a durian seed phytobezoar. This article...

Radiology is not a popular specialty for undergraduate student electives or postgraduate training amongst students from a local undergraduate medical school which is based in Southeast Asia. During the last 2 years (2007 & 2008), none of our elective students came from the local undergraduate medical school. During the...

Primary angiosarcoma of the lung is a rare, often difficult to diagnose disorder with non-specific respiratory manifestations. Angiosarcoma involving the lung is usually a result of metastatic disease. This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

The ability of multiphasic computed tomography (CT) and magnetic resonance (MR) studies in the diagnosis of liver tumours such as hepatocellular carcinoma and cholangiocarcinoma is well established. Nevertheless, potential mimics of malignant tumours abound. Hepatic tuberculosis presenting as hepatic mass is rare and preoperative diagnosis is usually difficult without...

It has been nearly 3 decades since tracheoesophageal puncture (TEP) with valve prosthesis placement was first introduced as an alternative means of achieving voice restoration in laryngectomised patients.1 Interestingly, it had initially been advocated as an alternative to those patients in whom oesophageal or electrolaryngeal speech had failed. This article...

Multi-detector Computed Tomography (MDCT) pulmonary angiography is currently the method of choice for the detection of acute pulmonary embolism (PE), because of its convenience, speed, sensitivity, direct clot visualisation and ability to provide alternative diagnoses that mimic PE clinically. This article is available only as a PDF. Please click on...

What do you see in the image? a) Deviated posterior nasal septum b) Nasopharyngeal tumour c) Rhinolith with mucous plug d) Bilateral choanal atresia e) Nasal pyriform aperture stenosis This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.

Recurrent laryngeal nerve (RLN) lies in close proximity with the thyroid gland. Thus, thyroid diseases, mainly the malignant ones, tend to cause irreversible recurrent laryngeal nerve damage due to the infiltration of the tumour cell. RLN damage due to benign lesion particularly from a solitary thyroid cyst is a...

Submandibular masses are common presenting complaints in the outpatient setting. The differential diagnosis of a submandibular mass lesion can be salivary gland pathology, lymph nodal disease or soft tissue conditions. The more common submandibular gland pathologies include sialadenitis, sialolithiasis, pleomorphic adenoma, lymphoma and carcinomas. This article is available only as...

Superior semicircular canal dehiscence (SSCD) can result in a characteristic constellation of vestibular and auditory features, including autophony, oscillopsia, and vertigo, and characteristic eye movements induced by sound and pressure changes. Patients with SSCD also show lowered thresholds for vestibular-evoked myogenic potentials (VEMPs) and a heightened sensitivity to bone-conducted...

Dear Editor, The buccal space is an infrequently addressed fascial space of the head and neck region. Intrinsic tumours of the buccal space are rare and hence present a management challenge. In a recent systematic review of 217 patients, 4 main surgical approaches were identified (intraoral, extended parotidectomy/rhytidectomy, transcutaneous...

A 74-year-old male with newly diagnosed melanoma of the right mastoid region, underwent resection of the lesion followed by F-18 fluoro-deoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for staging. Figure 1 demonstrates a whole body maximal intensity projection image while Figures 2 and 3 show cross-sectional images through the elbows...

I read with great interest the recent article published in the Annals of Academy of Medicine Singapore entitled, ‘Surgeon-Performed Ultrasound-Guided Fine Needle Aspiration Cytology (SP-US-FNAC) Shortens Time for Diagnosis of Thyroid Nodules, Ann Acad Med Singapore 2014;43:320-4’. Indeed, ultrasound-guided fine-needle aspiration (US-FNA) is an exceptionally valuable and simple approach...

Benign prostatic hyperplasia (BPH) is one of the commonest diseases of ageing men. It can be associated with bothersome lower urinary tract symptoms (LUTS) that affect quality of life and it causes structural and functional changes in the bladder. Previous clinical guidelines had emphasised on managing symptoms; however current...

The concept of first trimester screening (FTS) to evaluate the risk of fetal aneuploidies was first introduced in 1997 by Orlandi et al. The Fetal Medicine Foundation, London, has refined and populated this screening test that uses a combination of maternal age, nuchal translucency (NT) thickness and biochemical markers,...

As a follow-up to an earlier study comparing the attitudes of first year undergraduate medical students following the introduction of a new radiology curriculum in 2008 with their clinical seniors who did not have an early exposure to radiology; we again surveyed this same cohort of first year students...

Transthyretin amyloidosis (or ATTR amyloidosis) is an under-recognised multisystemic disorder, arising from misfolding of transthyretin proteins into insoluble amyloid fibrils. As amyloid fibrils deposit into various tissues and organs, the process invariably leads to organ dysfunction. Deposition of amyloid fibrils into the heart results in cardiac amyloidosis (CA). Manifestations...