Postpneumonectomy space infection eight years after mediastinal repositioning procedure

Postpneumonectomy syndrome is a rare complication following pneumonectomy. Repositioning of the mediastinum via insertion of prosthetic implants into the postpneumonectomy space can provide symptomatic relief. We present a case of a man in his early 70s presenting with empyema necessitans 8 years after the implantation of silicon-saline prostheses for the management of postpneumonectomy syndrome. Excision of the chest wall sinus, re-do right thoracotomy and removal of the infected silicon-saline prostheses and postprocedural intrapleural irrigation led to resolution. There was no evidence of mediastinitis. At the 1-year follow-up, the patient remained well, with a centralised mediastinum without further evidence of infection of the postpneumonectomy space. This is to our knowledge the first reported case of chronic infection of a repositioned mediastinum in the context of postpneumonectomy syndrome.