title: Pulmonary aspergilloma treated by limited thoracoplasty with simultaneous cavernostomy and muscle transposition flap.
abstract: We describe the successful treatment of pulmonary aspergilloma by limited thoracoplasty used simultaneously with single-stage cavernostomy and a muscle transposition flap. An 80-year-old man with dyspnea on effort and hemoptysis consulted our hospital. Chest computed tomography revealed a thick wall cavity containing a fungus ball surrounded by a crescent of air and diseased lung parenchyma, indicating complex pulmonary aspergilloma (CPA). As curative pulmonary resection was considered too invasive for this patient, limited thoracoplasty with simultaneous single-stage cavernostomy and myoplasty was performed as an alternative treatment. During the operation, transposition flap of the latissimus dorsi muscle was created by preserving the feeding artery. Fungus, in the ball that was removed, proved to be aspergilloma by culture and histopathological examination. On postoperative day 15, the patient was discharged uneventfully, and 4 months after surgery, no relapse of the aspergilloma has been observed.We consider that limited thoracoplasty with simultaneous single-stage cavernostomy and a muscle transposition flap is effective for treatment of high-risk CPA.
authors.affiliation: Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan. hitoshi-iga@hotmail.co.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Igai
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kamiyoshihara
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Nagashima
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ohtaki
mesh_terms: D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D009894:Opportunistic Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods; D055732:Pulmonary Aspergillosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013510:Pulmonary Surgical Procedures; D011859:Radiography; D013905:Thoracoplasty / Q000379:methods*; D016896:Treatment Outcome