VATS Trisegmentectomy Resection of Aspergilloma with Pan-Azole Resistance?

Pulmonary aspergillosis is a relatively rare disease and its management is sometimes difficult. Surgical resection is indicated in selected patients. We present a nationally unreported case (to the best of our knowledge) of VATS anatomical sublobar lung resection for isolated left upper lobe aspergilloma in a 55-year-old male with history of chronic pulmonary aspergillosis (CPNA). As adhesions prove to be a significant intra-operative obstacle, VATS segmentectomy can be ambitious, however this can be considered for simple aspergilloma in absence of severe pleural adhesions.