LOCALIZED WEGENER GRANULOMATOSIS RELAPSING AS DIFFUSE MASSIVE INTRAALVEOLAR HEMORRHAGE

In a 75-year-old patient presenting with a solitary pulmonary mass, a localized form of Wegener's granulomatosis was diagnosed after lobecto my. In the absence of extrapulmonary manifestations and after a benign postoperative course, the patient was discharged without medical trea tment. Three months later, diffuse alveolar hemorrhage developed abrup tly, necessitating mechanical ventilation, and was followed by cardiac complications and a fatal outcome. This case and another previously r eported strongly suggest the need for medical treatment in patients wi th a localized form of pulmonary Wegener's granulomatosis, even when c omplete remission after surgical resection of the lung lesion seems to have been achieved.