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A neurogenic dumbbell tumour is a rare occurrence in which the tumour has an extension through an intervertebral foramen, acquiring an hourglass shape. Surgical strategies to resect these tumours are rapidly evolving, and there is no definite consensus on the approach, stages, and plan of surgery. Here, we present a case report on a dumbbell tumour that was successfully resected via laminectomy and video-assisted thoracoscopic surgery (VATS) approach. A 53-year-old lady had an incidental finding of a mediastinal mass from chest radiography. Computed tomography (CT) and magnetic resonance imaging (MRI) studies showed a neurogenic mass with extension into the posterior mediastinum via the T1/2 neural foramina. A multi-disciplinary operation was planned for the patient, starting with neurosurgery resecting the intraspinal portion via laminectomy. The posterior mediastinal portion of the mass was resected via the right VATS approach and was successfully resected entirely. Her operation was complicated with a cerebrospinal fluid (CSF) leakage, requiring a revisit surgery. She was subsequently discharged well. Histopathology examination of the resected mass confirmed the diagnosis of schwannoma. Surgical resection of a dumbbell tumour is challenging because it involves both the thoracic and neurosurgical fields. There is currently no consensus on the best way to approach a tumour. Multiple articles have discussed various approaches, such as single-stage versus two-stage surgery, VATS versus open incisions, and the plan or sequence of the surgery. Dumbbell tumours need to be assessed on a case-by-case basis, and a multidisciplinary approach involving both neurosurgery and cardiothoracic surgery in deciding the best surgical approach could ensure a successful resection., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ng et al.)

Pulmonary metastases in soft tissue, such as sarcoma and osteosarcoma, are associated with a poor prognosis. A complete surgical resection has been proven to prolong survival. We report four cases of sarcoma with pulmonary metastases, all with differing progressions, prognoses, and management. This highlights the challenging nature of managing sarcoma with pulmonary metastases. Surgical metastatectomy remains the mainstay treatment for sarcoma with pulmonary metastases. Studies have demonstrated a significant survival benefit with complete surgical resection. There is currently no consensus on the size of the metastasis or the number of lesions for considering a patient inoperable. Surgical metastatectomy provides improved survival for sarcoma patients with pulmonary metastases. Management strategy is rapidly evolving with the emergence of new treatment methods. A case-by-case assessment and MDT approach are paramount in deciding the best course of action., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ng et al.)

Sternal osteomyelitis and mediastinitis are rare yet severe complications post-cardiac surgery, often associated with significant morbidity and mortality. Fungal etiologies, particularly those caused by Rhizopus spp., are infrequent but can lead to aggressive infections. Here, we present the case of a 68-year-old male who developed sternal osteomyelitis and mediastinitis caused by Rhizopus spp. two weeks following coronary artery bypass grafting surgery. Debridement and pectoralis flap reconstruction were performed following clinical identification and confirmation with microbiological examinations and a CT scan. Prompt recognition, aggressive surgical intervention, and targeted antifungal therapy were crucial for successful management. This case underscores the importance of considering fungal pathogens, such as Rhizopus , in the differential diagnosis of post-cardiac surgery infections, as well as aggressive treatment to improve outcomes for affected patients., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Tiew et al.)