Aspergilloma within cavitating pulmonary adenocarcinoma

Pulmonary aspergillosis not infrequently occurs secondary to various malignancies and their associated therapies, but the simultaneous occurrence of Aspergillus and lung cancer is rare. The authors report the case of a 64-year-old male, who presented with a cavitating left upper lobe lesion radiologically, consistent with either fungal infection or carcinoma. Pathologically, the lesion was a thin-walled adenocarcinoma with a large central cavity containing an aspergilloma intermingled with highly necrotic tumor. This represents the fifth such reported case.