Spontaneous resolution of a giant pulmonary bulla: what is the role of bronchodilator and anti-inflammatory therapy?

Spontaneous resolution of giant pulmonary bullae occurs infrequently. The mechanisms responsible for the natural elimination of giant bullae are variable. We report a patient who experienced spontaneous total regression of his giant bulla following intensification of his inhaled bronchodilator and airway anti-inflammatory therapies. This occurrence suggests that smoking cessation and optimization of inhaled bronchodilator and anti-inflammatory therapies should be undertaken before referral for surgical bullectomy. These relatively simple measures may obviate the need for an invasive procedure.