This retrospective study suggests that emergency lung resection is feasible in appropriately selected patients presenting with radiologically localized disease and massive haemoptysis. These data also suggest that BAE is probably best utilized as a temporizing measure in patients unsuitable for emergency lung resection.

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Desmoid tumours are rare monoclonal fibroblastic proliferations arising in the soft tissue and accounting for less than 0.03% of all neoplasms. These benign neoplasms are locally invasive and tend to recur, but do not metastasise. Desmoid tumours generally occur between the ages of 15 and 60 years. [1,2] Two different types have been described: a sporadic type, and a familial type in which the tumours are usually intraabdominal. [2,3] The chest wall is the most common site for extraabdominal desmoid tumours, with true intrathoracic tumours being extremely rare. Patients with intrathoracic desmoid tumours are usually asymptomatic and generally present when the lesion is large enough to cause compression of vital structures or erosion into adjacent bone or joints. These tumours resemble sarcomas both clinically and histologically. Although not specific, beta-catenin and mutations thereof are highly sensitive for sporadic desmoid tumours. [3] Firstline therapy is complete surgical resection if this will not result in unacceptable morbidity.

Lung resection for DR-TB may be safely undertaken in selected patients who are HIV-positive with cure rates equivalent to that of HIV-negative patients. More importantly, these patients also have significantly higher cure rates than those patients treated with medical therapy alone.

Background Adjuvant lung resection in patients with drug-resistant tuberculosis (DR-TB) not only is cheaper than a 2-month course of drug therapy for multidrug-resistant tuberculosis (MDR-TB) but also, more importantly, has a higher cure rate than medical therapy alone. The cure rate for some MDR-TB patients treated with adjuvant lung resection is about 90%. With the more severe forms of DR-TB, surgical cure rates in selected patients remain high, whereas cure rates decrease when only medical therapy is used. In addition, adjuvant lung resection for DR-TB in selected patients with HIV co-infection does not appear to have a higher complication rate. Objectives To determine whether specialist pulmonologists in South Africa utilise thoracic surgical intervention for DR-TB appropriately. Methods A cross-sectional survey was conducted among pulmonologists of the South African Thoracic Society. The study tool was a predesigned, anonymous questionnaire that included 17 closed-ended questions about the role of cardiothoracic surgery in the management of DR-TB. Results A 50% response rate was achieved. The majority of respondents did not know the indications for adjuvant lung surgery in the setting of DR-TB, but would have altered their referral behaviour had they been aware of these indications. Conclusion Participating pulmonologists’ uncertainty regarding optimal use of adjuvant lung resection for DR-TB suggests the need for local guidelines and education initiatives relevant to the management of these patients. These strategies should include the participation of both the pulmonologist and the cardiothoracic surgeon.