Lung abscess: a fatal complication of treatment for testicular teratoma

We describe a patient with widely metastatic testicular teratoma who responded to intensive combination chemotherapy but developed a lung abscess in a necrotic tumour cavity, leading to death before surgical resection of residual lesions could take place. Post-mortem examination revealed necrotic tissue and mature differentiated teratoma, with no evidence of frank malignancy. This complication has not been previously reported in treated teratoma. Resolution of an abscess developing in a pre-existing thick-walled lesion is less likely with antibiotics alone. Awareness of this might salvage potentially curable cases by earlier surgical intervention.