Ruptured mediastinal mature teratoma with shigellosis empyema: A case report

Introduction and importance: Mediastinal mature teratomas are often benign and asymptomatic, but ruptured mediastinal mature teratoma is rare and induces severe complications. Case presentation: A male, 23 year old, complained shorthness of breath, right chest pain, fever, and cough. Radiological examination (X-ray, CT-Scan and MRI) showed mediastinal teratoma and pleural effusion. The patient received supportive therapies, including oxygen, symptomatic therapy, antibiotics, and lateral thoracotomy. Empyema culture was positive for Shigella dysenteriae. He was discharged after thirty-six days of hospitalization in good clinical condition. Clinical discussion: Perforation of mature teratoma is a rare but severe complication. Ruptured mediastinal teratoma can cause extensive pleural adhesions and empyema, making it challenging to perform VATS because of the risk of bleeding and damage to adjacent organs during surgery. Conclusion: Ruptured mediastinal mature teratoma has a good prognosis post-surgical partial resection despite tumor attachment to the pericardium and heart.