Clinicians Think Cancer, but Cessation of E-Cigarette Use Vaporizes the Diagnosis

electronic cigarette
electronic cigarette
The patient stated that she had stopped vaping after her first referral, as she presumed a diagnosis of cancer.

Although it has gained worldwide popularity as a smoking substitute, only a few randomized controlled trials have been conducted on the safety of vaping (using e-cigarettes). The FDA previously raised concerns surrounding its safety after chemical analyses found carcinogens and toxic chemicals in vaping liquids. A new case has emerged highlighting a unique reaction that hammers home how little is yet known of the effects on the body vaping can have.

The case details a 45-year old woman referred to a clinic due to suspected disseminated malignant disease. She had presented with abdominal pain and fever which occurred intermittently for 4-weeks. As part of her work-up, a full-body CT scan was performed.  The CT scan revealed numerous nodules in the lungs as well as liver lesions highly indicative of metastases. Findings were further supported by a fluorodeoxyglucose-PET scan which also showed a positive area in the left ovary.

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At the clinic, the patient looked to be in good health; her physical examination showed no signs of illness. C-reactive protein levels were moderately elevated, and liver, kidney, endocrinologic, hematologic, rheumatologic, and tumor biomarkers were all in normal ranges. Sarcoidosis, amyloidosis, rheumatoid arthritis, and chronic infectious disease were all excluded as possible diagnoses.

All other examinations showed up normal, flummoxing the doctors. A positive tumor response was noted through PET scan and was resected throacoscopically, however, it was identified as just inflamed tissue with no malignancy. Biopsy of a liver lesion showed unspecific reactive changes.