[Renal aspergilloma: first manifestation of an occult sarcomatoid carcinoma]

A patient with b-symtoms and a sonographically detected kidney tumor entered hospital for a nephrectomy. An aspergillosis had been histologically accounted for. Up to that point, there was no indication of an immunodeficiency or invasive aspergillosis. Three months later, the patient was readmitted to hospital due to an indefinite retroperitoneal and hepatic mass on the right side. A punch biopsy ascertained a remanifestation of an aspergillosis at both localizations. The mass increased during systemic and antimycotic therapy, indicating the surgical resection of hepatic and retroperitoneal findings. The histological report yielded the diagnosis of a poorly differentiated sarcomatous carcinoma. Thus, an aspergillosis was the initial manifestation of what had up to that point been an occult sarcomatous carcinoma.