The authors thank your valuable comment. While we consider important the need for comparative studies of the medical and surgical treatment, it is clear that hemoptysis is the most common form of presentation of aspergilloma, with an incidence of approximately 80%,¹ 81.8% in our serie,² and this is definitely surgical indication in the treatment of cavitated lesions.

It is also worth mentioning that surgery in aspergilloma must be indicated from the time of diagnosis, even in patients without hemoptysis, since studies show conclusively that approximately 30% of patients with minor hemoptysis, might develop hemoptysis to compromise the life.³ In addition, the prognosis varies if a patient is operated on electively and stable, compared to what is involved in the emergency and bleeding episode.

Conservative treatment should be limited to specific situations, such as patients with pulmonary functional reserve decreased, or in selected cases as published by you, in which, we assume that his patient was not a candidate for surgical treatment oncologically.^1),(4