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. 2025 Jun 18;13(6):e70252.
doi: 10.1002/rcr2.70252. eCollection 2025 Jun.

When Teratoma Masquerades: A Rare Case of Intrapleural Mature Cystic Teratoma Mimicking Tuberculous Empyema

Nik Nuratiqah Nik Abeed  1 , Ng Boon Hau  1 , Nor Safiqah Sharil  2 , Andrea Ban Yu Lin  1 , Marfua'h Nik Ezzamudin  3 , Hairulfaizi Haron  4
Affiliations

When Teratoma Masquerades: A Rare Case of Intrapleural Mature Cystic Teratoma Mimicking Tuberculous Empyema

Nik Nuratiqah Nik Abeed et al. Respirol Case Rep. .

Abstract

Teratomas are germ cell tumours generally gonadal in origin and very rare, arising from extra gonadal tissue. The most common extragonadal teratomas are mediastinal, and the majority are benign. We report a case of a 49-year-old lady with recurrent right complex pleural effusion occurring a month after the completion of treatment for tuberculous empyema. Imaging from ultrasound of the thorax and contrasted enhanced computed tomography (CECT) thorax revealed multiseptated and loculated effusion in the thorax without any mediastinal and lung involvement. Surprisingly, pleural fluids were negative for tuberculosis. Despite chest drainage and initial treatment for bacterial empyema without improvement, she underwent video assisted thoracoscopy and decortication of the right pleura, and histopathological analysis revealed a mature cystic teratoma. She was discharged in good health and under yearly surveillance. The rarity of intrapleural mature cystic teratoma and its misleading presentation due to the concurrent tuberculous empyema make this case noteworthy.

Keywords: cystic; intrapleural; mature; teratoma.

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Conflict of interest statement

A.B.Y.L. is an Editorial Board member of Respirology Case Reports and a co‐author of this article. She was excluded from all editorial decision‐making related to the acceptance of this article for publication. The other authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
(A) Chest radiograph showed right moderate pleural effusion; (B) CECT coronal view showed right pleural effusion; (C) CECT surveillance post decortication showed resolving right pleural effusion; (D) Pleural fluid showed proteinaceous yellowish fluid; (E) Cheesy mass embedded in parietal pleural via video assisted thoracoscopy; (F) Pleural tissue with the tumour 8 cm length.
See this image and copyright information in PMC

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