Invasive pulmonary aspergillosis presenting as thoracic mass causing obstruction of the superior and inferior vena cava in an immunocompetent patient: a diagnostic dilemma.

Invasive pulmonary aspergillosis (IPA) is a disease of immunocompromised patients, but its prevalence is increasing in immunocompetent persons. Patients usually present with non-specific symptoms, sometimes consistent with bronchopneumonia. We discuss the case of a 19-year-old boy who presented with constitutional respiratory symptoms along with signs of obstruction of the superior and inferior vena cava. A chest radiograph was suggestive of a thoracic mass raising suspicion of bronchogenic carcinoma/ benign mass, sarcoidosis and tuberculosis, but a diagnosis of invasive aspergillosis was established. The patient showed excellent clinico-radiological improvement with administration of voriconazole. Invasive pulmonary aspergillosis may also present with atypical findings and should be considered in differentials when investigating a case even if the patient does not have a risk factor.

Management of bronchovascular mucormycosis in a diabetic: a surgical success.

Although cases of pulmonary mucor are scarce, diabetics account for a large percentage of these patients. The synergism of diabetes mellitus and mucormycosis poses potentially devastating bronchopulmonary complications, warranting urgent intervention. This report reviews the efficient workup, along with successful medical and surgical management, of a patient with pulmonary mucormycosis, with evidence of superior vena cava invasion.