Behind the Façade: Robotic-Assisted Resection of a Diaphragmatic Osteochondroma.

Neoplasms arising from the diaphragm are not typically seen in clinical practice, though they may inflict significant morbidity and mortality. In the realm of thoracic surgery, osteochondromas are only encountered at the thoracic wall or vertebra. In this study, we describe a case of an osteochondroma arising from the diaphragm masquerading as a malignant lesion. The tumor was resected via robotic-assisted means and the patient was discharged with no complications.

Malignant Pleural PEComa: A Previously Undocumented Site.

Perivascular epithelioid cell (PEC) tumors are rare tumors of mesenchymal origin and can affect many anatomic regions. Although these tumors are usually benign, malignant variants exist. We document for the first time a malignant PEComa arising from the pleura of a 43-year-old Malay woman. The pathology of the tumor as well as differential diagnoses is discussed.

Managing a case of extensively drug-resistant (XDR) pulmonary tuberculosis in Singapore.

INTRODUCTION: Extensively drug-resistant tuberculosis (XDR-TB) is an emerging global health risk. We present the first case report of XDR-TB in Singapore. CLINICAL PICTURE: A 41-year-old Indonesian lady with previously treated pulmonary tuberculosis presented with chronic cough. Her sputum was strongly acid-fast bacilli positive and grew Mycobacterium tuberculosis complex resistant to first and second-line TB medications. TREATMENT: She received 5 months of intensive multidrug treatment without sputum smear conversion. She then underwent resection of the diseased lung. The total cost incurred amounted to over S$100,000. OUTCOME: She achieved sputum smear/culture conversion post-surgery, but will require further medical therapy for at least 18 months. CONCLUSION: XDRTB is poorly responsive to therapy and extremely expensive to manage. Its prevention by strict compliance to therapy is paramount.