Invasive pulmonary aspergillosis: A rare complication after microwave ablation

Abstract

Three cases are reported of invasive pulmonary aspergillosis (IPA) occurring after microwave ablation (MWA) for lung tumours. This is a rare complication that has not previously been described in the literature. The diagnosis of IPA was based on the following factors: host factors, clinical manifestations and mycological findings. The first case was a 63-year-old man treated for primary lung squamous carcinoma. Significant tumour regression was achieved by 18 days after MWA, medical treatment with itraconazole for 6 weeks, and postural drainage. The second case, a 65-year-old man, was confirmed with primary lung squamous cell carcinoma. Voriconazole administration using intravenous infusion combined with intracavitary lavage was therapeutically effective after MWA at 1 year follow-up. The third case was a 61-year-old woman with primary lung adenocarcinoma. Delayed pneumothorax and bronchopleural fistula secondary to IPA persisted. The patient died from secondary multiple organ function failure. Despite its very low incidence, the significance of early diagnosis and early administration of antifungal therapy should be highlighted because of the relentless severity of IPA in patients undergoing MWA.

Enhancement of Intratumoral Chemotherapy with Cisplatin with or without Microwave Ablation and Lipiodol. Future Concept for Local Treatment in Lung Cancer

“…al. 36 invasive aspergillosis occurred after microwave ablation. Our current study was based on the concept that a lipophilic substance, such as lipiodol can enhance the thermal effect of microwave ablation.…”

Invasive pulmonary aspergillosis secondary to microwave ablation: a multicenter retrospective study

“…Despite being a minimally invasive procedure, MWA can cause major complications [5][6][7]13]. Invasive pulmonary aspergillosis (IPA), a life-threatening and common complication secondary to MWA, was rarely reported previously [14]. The goals of this retrospective multicenter study were to investigate the incidence and clinical and radiologic manifestations of IPA in patients who underwent MWA and to analyze the treatment outcomes, mortality rate and possible risk factors.…”

Aspergillosis complicating a microwave ablation cavity

“…Cavities usually involute and disappear leaving minor architectural distortion of the surrounding lung after 2 months 5. Semi-invasive aspergillosis has previously been reported as a complication of MWA, but in those cases, this was an immediate complication developing within 2–4 weeks 6. However, in this case, the MWA cavity preceded the infection by 2 years and semi-invasive aspergillosis developed after three cycles of doxorubicin.…”