title: A Cancer That Went Up in Smoke: Pulmonary Reaction to e-Cigarettes Imitating Metastatic Cancer.
abstract: e-Cigarettes have gained worldwide popularity as a substitute for smoking, but concern has been raised regarding the long-term effects associated with their use. We report a case of a 45-year-old female consumer of e-cigarettes who presented with 4 months of abdominal pain and fever. Initial imaging discovered multiple pulmonary nodules and liver lesions suspicious of widespread metastases; however, an extensive evaluation found no evidence of malignancy. Results of a lung biopsy revealed an area with multinucleated giant cells suggestive of a foreign body reaction to a lipophilic material. Upon cessation of e-cigarette use (known as vaping), the lung nodules disappeared, and the liver lesions regressed. Our case report suggests that vaping can induce an inflammatory reaction mimicking metastatic cancer.
authors.affiliation: Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: leemas@rm.dk.
authors.forename: Lene
authors.initials: L
authors.lastname: Ring Madsen
authors.affiliation: Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels Henrik
authors.initials: NH
authors.lastname: Vinther Krarup
authors.affiliation: Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Troels Korshøj
authors.initials: TK
authors.lastname: Bergmann
authors.affiliation: Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Bærentzen
authors.affiliation: Department of Radiology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Shadman
authors.initials: S
authors.lastname: Neghabat
authors.affiliation: Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Duval
authors.affiliation: Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Søren Tang
authors.initials: ST
authors.lastname: Knudsen
mesh_terms: D003937:Diagnosis, Differential; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects*; D005260:Female; D005549:Foreign-Body Reaction / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000175:diagnosis* / Q000209:etiology; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
keywords: biopsy (lung); chest imaging; foreign bodies; inflammation; smoking