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Schwannomas are nerve sheath tumors that occur in Schwann cells. They are usually benign, but malignant transformation can occur. Symptomatology depends on the involvement of the surrounding tissues or the mass effect of the tumor. We describe a case of a 28-year-old man who initially presented with right iliac fossa pain associated with radiating pain over the anterior and lateral aspect of his right knee. Following subsequent investigations, we found a retroperitoneal schwannoma of the right lateral femoral cutaneous nerve. The key to our diagnosis was the referred pain to his right knee, which gave us a clue of possible neuropathic pain. Our patient highlights the need to consider a unified diagnosis when faced with an incongruent set of symptoms. Magnetic resonance imaging is the diagnostic modality of choice for the diagnosis of schwannomas. Treatment is directed towards symptomatic control. Surgery, radiation, and, in rare instances, chemotherapy are the major treatment modalities employed.

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Physicians play a pivotal role in the management of children and adults with Down Syndrome. Achieving full developmental potential in a child with Down Syndrome depends on prompt treatment of medical complications, family support and early establishment of intervention programmes. The presence of evidence-based guidelines support the physician both in the community and in restructured hospitals to provide timely and appropriate management recommendations. It will also aid in counselling parents and caregivers. Although most co-morbidity characteristics are common for the syndrome, the prevalence of different morbidities can be region specific, hence it is useful to have recommendations tailored to suit local population. Here we share the clinical guideline for children and adults with Down Syndrome in Singapore.