Aspergilloma mimicking postoperative recurrence of squamous cell lung cancer: A case report

Introduction: Pulmonary aspergilloma (PA) is a common clinical manifestation of lung infection caused by Aspergillus species. In addition to tuberculosis and chronic obstructive pulmonary disease, which are considered the most frequent underlying conditions, lung cancer is also recognized as an important etiopathogenetic factor. Case Report: A chest computed tomography (CT) scan performed six months after thoracoscopic right upper lobectomy for primary squamous cell lung carcinoma (three months after completing chemotherapy) revealed a spiculated lesion in the apical segment of the ipsilateral lower pulmonary lobe, measuring 28×39×42 mm. Fine-needle aspiration biopsy (FNAB) and serological testing confirmed Aspergillus species as the etiological agent of the pulmonary mass. The patient underwent conservative antifungal therapy, starting with 14 days of intravenous voriconazole during hospitalization, followed by oral itraconazole for six weeks post-discharge. Notably, he remained asymptomatic both prior to diagnosis and throughout treatment. Follow-up chest CT scans revealed complete resolution of the pulmonary aspergilloma, with residual calcified fibrous tissue consistent with chronic post-treatment changes. Conclusion: This case underscores the importance of considering PA in the differential diagnosis of new lung lesions detected after lung cancer surgery, given its ability to closely mimic tumor recurrence.