Localized invasive pulmonary aspergillosis in patients with neutropenia. Effectiveness of surgical resection

Cancer. 1993 Dec 1;72(11):3223-6. doi: 10.1002/1097-0142(19931201)72:11<3223::aid-cncr2820721115>3.0.co;2-r.


Background: Invasive pulmonary aspergillosis (IPA) is a major cause of morbidity and mortality in patients with neutropenia. Two severe complications with poor outcome can be observed after apparently successful IPA medical treatment: severe hemoptysis and IPA relapse during subsequent cytotoxic treatments. Early surgical therapy has not been considered routinely in the management of localized IPA.

Methods: Six consecutive patients (four women, two men; median age, 52 years) with localized cavitating IPA diagnosed during chemotherapy-induced aplasia were treated with early surgical resection after hematologic recovery.

Results: All patients received a lobectomy. Surgery was uneventful. This procedures allows patients to proceed with further intensive chemotherapy and/or bone marrow transplantation without IPA reactivation.

Conclusions: For selected patients, surgical resection of localized IPA with unique cavitating lesion, which prevents hemoptysis and IPA recurrence and allows for subsequent cytotoxic treatment, may be recommended.

MeSH terms

  • Adult
  • Amphotericin B / administration & dosage
  • Amphotericin B / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Aspergillosis / complications
  • Aspergillosis / drug therapy
  • Aspergillosis / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunocompromised Host*
  • Leukemia, Myeloid, Acute / drug therapy
  • Lung Diseases, Fungal / complications
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / surgery*
  • Male
  • Middle Aged
  • Neutropenia / chemically induced
  • Neutropenia / complications*
  • Pneumonectomy
  • Survival Rate
  • Time Factors


  • Amphotericin B