Aspergillosis complicating a microwave ablation cavity. (13th September 2016)

• Record Type: Journal Article
• Authors: Singh, Saurabh; Bandula, Steven; Brown, Jeremy; Whelan, Jeremy; Illing, Rowland
• Is Part Of: BMJ case reports. Volume 2016
• Publication Date: 2016-09-13
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2016-216438
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We present a case of a patient who following chemotherapy developed semi-invasive pulmonary aspergillosis and an aspergilloma in a lung cavity previously formed by microwave ablation (MWA). A 55-year-old woman presented with cough and shortness of breath after finishing three cycles of chemotherapy for a metastatic nerve sheath tumour. She had been treated by MWA for pulmonary metastases 2 years previously which resulted in a residual right apical lung cavity. Postchemotherapy imaging showed that this cavity had enlarged, developed a thicker wall and contained lobulated soft tissue with a crescent sign on coronal reformats. In addition, the patient's Aspergillus -specific IgG was markedly raised. Treatment with itraconazole improved the symptoms and reduced the cavity size and wall thickness. This case shows that persisting lung cavities after MWA are a potential site for semi-invasive aspergillosis and has implications for the timing of chemotherapy in patient with metastatic lung disease.