Turk Gogus Kalp Dama 2012;20(2):381-383 381 Türk Göğüs Kalp Damar Cerrahisi Dergisi Turkish Journal of Thoracic and Cardiovascular Surgery doi: 10.5606/tgkdc.dergisi.2012.075 Intracavitary aspergilloma after hydatid cyst surgery: a case report Akciğer kist hidatik cerrahisi sonrasında intrakaviter aspergilloma: Olgu sunumu Hakan Kıral, 1 İrfan Yalçınkaya, 1 Mustafa Küpeli, 1 Recep Demirhan 2 1 Department of Thoracic Surgery, Süreyyapasa Chest Disease and Chest Surgery Training and Research Hospital, İstanbul, Turkey; 2 Department of Thoracic Surgery, Dr. Lütfi Kırdar Kartal Training and Researh Hospital, İstanbul, Turkey Dört yıl önce başka bir merkezde sağ akciğerde kist hidatik nedeniyle kistotomi ve kapitonaj ameliyatı yapılan hasta, tekrarlayan hemoptizi yakınması ile kli- niğimize başvurdu. Göğüs bilgisayarlı tomografide sağ alt lob posterior segmentte yerleşik kaviter lezyon tespit edildi. Hastaya, hemoptizi ve kaviter lezyon nedeniyle, tekrar torakotomi ve sağ alt lobektomi yapıldı. Patolojik inceleme bronşektazi, parenkim içi hemoraji ve intraka- viter aspergilloma olduğunu ortaya çıkardı. Kist hidatik ameliyatları sonrası kalan rezidüel boşlukların içinde de aspergilloma gelişebilir. Bu yazıda cerrahi teknik, takip ve tedavide bu patolojinin dikkate alınması gerektiği- ni vurgulamak amacıyla, çok nadir rastlanan bir olgu sunuldu. Anahtar sözcükler: Aspergilloma; kapitonaj; kistotomi; pulmo- ner kist hidatik. The patient who underwent cystotomy and capitonnage surgery of right lung due to a hydatid cyst four years ago in another centre was admitted to our clinic with the complaint of recurrent hemoptysis. Chest computed tomography revealed a cavitary lesion located in the posterior segment of the right lower lobe. Rethoracotomy and right lower lobectomy were performed in the patient for hemoptysis and cavitary lesion. Pathological examination showed bronchiectasis, intraparenchymal hemorrhage and intracavitary aspergilloma. Aspergilloma may develop within residual cavities after pulmonary surgery for hydatid cyst. In this article, a very rare case was presented to emphasize the significance of this pathology for surgical technique, follow-up and treatment. Key words: Aspergilloma; capitonnage; cystotomy; pulmonary hydatid cyst. Received: August 17, 2009 Accepted: November 12, 2009 Correspondence: Hakan Kıral, M.D. Süreyyapaşa Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi, 34844 Maltepe, İstanbul, Turkey. Tel: +90 216 - 421 42 00 e-mail: kiralhakan@yahoo.com Hydatid cyst is a zoonotic disease caused by Echinococcus granulosus while Aspergillus is a saprophytic fungus which leads to allergic pulmonary aspergillosis and aspergilloma along with semi-invasive and invasive aspergillosis. [1] Pulmonary aspergilloma generally develops within a previously existing cavity in the lungs. Tuberculosis, sarcoidosis, bronchiectasis, and some other cavitary pulmonary diseases may be complicated with aspergilloma. Tuberculosis is the disease which is most commonly accompanied by aspergilloma, but its concurrence with Aspergillus and hydatid cyst is a rare condition. In the literature, there are only a few case reports regarding this concurrence. CASE REPORT A 20-year-old male was admitted to our department complaining of recurrent hemoptysis. Four years previously, he had undergone a cystotomy and capitonnage at another center with no perioperative and postoperative complications. The patient had complained of cough and bloody sputum two years before arriving at our facility, but he recovered from this spontaneously within a short period of time. His cough and hemoptysis developed suddenly seven months prior to his admission, and he had a hemorrhage of about 200 ml. A bit later, he had occasional small amounts of hemoptysis, which ultimately resulted in his referral to our department for surgical evaluation. The patient’s history revealed nothing special except for the previously mentioned pulmonary surgical procedure due to a hydatid cyst. The physical examination findings were normal, and no special features were determined by routine laboratory examination. Computed tomography (CT) revealed a cavitary lesion located on the posterior Case Report / Olgu Sunumu