2006 - UZ Leuven

east implant. Only two other cases of aspergilloma of the breastwere reported in the literature. In both cases the aspergilloma wastreated by surgical excision. In our patient, primary surgery wouldhave caused considerable cosmetic damage due to the size of thelump and the subcutaneous fistulae: furthermore the patient was veryreluctant to undergo surgery. The usual presentation is a painless noninflamed lump in the breast that could be easily mistaken for a breastcarcinoma. As in all breast lumps, correct imaging and ultrasoundguided biopsy should be performed. In immune suppressed patients aculture of the aspirate is advisable. The clinical response to acombination of voriconazole, amphotericine B and capsofungin wassuboptimal. With pozaconazole, the mass disappeared and totalclinical and MRI regression was obtained after almost one year. MRIhas proven to be an additional tool in evaluating the response to themedication.38