Abstract Introduction Thoracic Oncology practice in an area with endemic mycoses poses unique challenges to practicing clinicians. We present a case of a patient with a lung mass that demonstrated lung adenocarcinoma and coccidioidomycosis coinfection. Case Description A 63-year-old male with a 40-pack year smoking history presented to the pulmonary clinic for evaluation of a lung mass (Image 1) . The patient received Robotic bronchoscopy assisted transbronchial biopsies(image 2) that revealed lung adenocarcinoma and coccidioidomycosis coinfection (image 3, 4). Serum immunodiffusion and compliment fixation titers were negative, likely indicating early infection. The patient was treated with concurrent doublet chemoradiation and planned for adjuvant immunotherapy based on NGS testing. The patient was concurrently treated for coccidioidomycosis infection with oral fluconazole. Discussion In the authors search of the medical literature, this represents the first documented case of coinfection of Coccidioidomycosis within a lung cancer. The implication of this finding is profound, since immunosuppression may contribute to dissemination of the fungal disease. Coccidioidomycosis titer 1: 16 is strongly associated with disseminated infection, which fortunately was not the case for this patient. The patient continues to receive therapy without adverse outcomes. This abstract is funded by: none
Manglani et al. (Fri,) studied this question.