Mature teratoma is the most common primary germ cell tumor in the mediastinum. On rare occasions, cystic teratomas rupture in adjacent structures, such as pleural space, pericardium, lung or tracheobronchial tree. We present a case of a mediastinal mature cystic teratoma in 16-year-old female with complex rupture into the lung, bronchus and skin. Mature mediastinal teratoma fistulized to the skin has not been previously described.

Background Pulmonary aspergilloma presents in two clinical and radiological forms: simple and complex aspergilloma. Surgery is the best therapeutic option, most often by anatomic lung resection. Our aim was to report the surgical outcomes according to our experience. Methods A retrospective study was conducted on data of 79 patients operated on for pulmonary aspergilloma over a period of 10 years. There were 57 (72.15%) men and 22 women (27.84%), with a mean age of 40.45 years. Results Tuberculosis, all-form combined, was the predominant pathological antecedent in 57 (72.15%) patients, and hemoptysis was the most frequent functional sign in 43 (54.43%). The right side was involved in 39 (49.36%) patients. All patients were operated on via a posterolateral thoracotomy, and an extrapleural plane was necessary in 40 (50.63%). The surgical procedure was a lobectomy in 38 (48.10%) patients and a pneumonectomy in 14 (17.72%). Transfusion of red blood cells was carried out in 10 (12.65%) patients, with one (1.26%) requiring a rethoracotomy for postoperative clotted hemothorax. Two (2.53%) patients presented with empyema after pneumonectomy. The mortality rate was 2.53% (2 patients), and the mean follow-up was 2.5 years. Conclusion Surgery for pulmonary aspergilloma is associated with a high rate of morbidity and mortality. This surgery has been performed in our department with a very acceptable rate of mortality, especially considering that all patients were operated on by open surgery.

Postpneumonectomy empyema is a collection of pus in the pleural space after removal of the underlying lung. Postpneumonectomy empyema is a serious complication responsible for high rates of morbidity and mortality. Several risk factors for the development of postpneumonectomy empyema have been highlighted in the literature. The association of postpneumonectomy empyema with a bronchopleural fistula increases the rate of mortality by flooding the remaining lung. The management of postpneumonectomy empyema depends on the timing of presentation and the presence or absence of a bronchopleural fistula. The goals of care in the acute period are mainly preservation of the contralateral lung and sterilization of the pleural space, which may take a considerable time. The aims in the late period are closure of the bronchopleural fistula, obliteration of the pleural space, and closure of the chest wall.