The possible association between the risk of pancreatic cancer mortality and hardness levels in drinking water from municipal supplies was investigated in a matched case-control study in Taiwan. All eligible pancreatic cancer deaths (883 cases) of Taiwan residents from 1990 through 1994 were compared with deaths from other causes (883 controls), and the hardness levels of the drinking water used by these residents were determined. Data on water hardness throughout Taiwan was collected from Taiwan Water Supply Corporation (TWSC). The control group consisted of people who died from other causes and were pair matched to the cancer cases by sex, year of birth, and year of death. The results show that there is a 39 % excess risk of mortality from pancreatic cancer in relation to the use of soft water. Trend analyses showed an increasing odds ratio for pancreatic cancer with decreasing levels of hardness in drinking water. This is an important finding for the Taiwan water industry and human health.

Abdominal leiomyomas are extremely rare intra-abdominal tumors. We present a the case of a 24-year-old male with an abdominal leiomyoma who presented with a chief complaint of a huge mass in the midepigastrium that was suddenly detected 5 days prior to admission. An abdominal leiomyoma with central hemorrhage was found on exploratory laparotomy; the tumor was completely resected. To the best of our knowledge, no similar case has been reported in the literature.

# CASE HISTORYA 35-yr-old obese male was admitted to the Tri-Service General Hospital (Taipei, Taiwan) for further examination of an abnormal opacity seen on a chest radiograph obtained during a medical check-up. The patient had been asymptomatic and had never received any treatment with steroids. Physical examination was unremarkable. Laboratory data, including complete blood count and tumour markers, were within normal limits. Abnormal laboratory findings from serological test were as follows: cholesterol 225 mg?dL -1 ; aspartate aminotransferase 45 IU?L -1 ; and alanine aminotransferase 61 IU?L -1 . The initial chest radiograph and computed tomography (CT) scan are seen in figures 1 and 2, respectively.The patient underwent mass resection via sternotomy. An oversized tumoural thymus (the first specimen) was resected in toto. However, the resected tumour was not comparable in size to the lesion discovered on CT imaging. A decision was made to incise the mediastinal pleura for confirmation of the pre-operative CT findings. A sizeable, whitish soft mass (the second specimen) was uncovered in the mediastinum, adjacent to the aortic arch. No attachment was found between the tumour and either the bronchial tree or oesophagus. Surgical excision of the tumour was performed. The histological findings of both specimens are shown in figures 3 and 4. FIGURE 2. Contrast-enhanced computed tomography chest scan cut (mediastinal window) at initial presentation.