A man in his 20s has suffered a one-in-a-million type of cancer that could be linked to his vaping habit.
The 23-year-old, of Indonesian origin, was diagnosed with a tumor called synovial carcinoma, which kills around 70 percent of its victims.
The tumor had grown in the tissue between his lungs, pushing his heart to one side and preventing it from pumping blood properly.
The patient had been using e-cigarettes for about five years before experiencing health problems that affected him for three months before he was diagnosed with the disease.
Vaping has been shown to potentially increase the risk of cancer, although doctors cannot confirm whether it was linked to the new patient’s tumor.
The patient’s scan shows a mass on his right side near his lung, which was pressing against his heart (shown on the right side of the image, but it is the left side of his chest).
The young patient had been a regular user of e-cigarettes for approximately five years prior to his diagnosis.
The young man came to the hospital with difficulty breathing for about two months, which worsened when he was lying down, and had had chest pain and a cough for three months.
He also lost 11 pounds in that time.
A physical examination showed that he had general weakness, an asymmetrical chest shape, decreased vibrations felt through the chest wall in the upper right chest, a dull sound when tapping on the upper right chest, and reduced breath sounds in the same area.
His The doctors began a series of diagnostic imaging tests, including X-rays and CT scans.
A CT scan showed a tumor on the right side of the chest, near the lung. Another showed the solid mass was compressing veins in the lung, the left side of the heart, a crucial artery leading to the right lung and the right middle lobe of the lung.
The tumor was the length of a large tablet, the width of a dinner plate and the height of a medium melon.
His heart was also surrounded by fluid and his lymph nodes were enlarged. Compression of several structures in the man’s chest reduced oxygen flow to his lungs, leading to breathing difficulties and impaired heart function.
Doctors said: ‘Synovial sarcoma appears macroscopically as a well-defined mass with variable size, ranging from 5 to 23 cm (approximately two to nine inches), with a soft to firm texture and invasion of surrounding tissues.
The mass was pressing on his heart and other organs. It was about the length of a pill and the width of a small melon.
‘A definitive diagnosis of synovial sarcoma can be difficult, even after taking a tissue sample. Immunohistochemistry can be helpful, but is not sufficient, as the tumor may histologically resemble other soft tissue tumors.’
Vaping has been linked to an increased risk of lung cancer. While it doesn’t produce cancer-causing smoke like cigarettes do, e-cigarette liquid contains thickeners and heavy metals that damage lung tissue.
A study in South Korea last year analyzed health data from 4.3 million former smokers and found that those who switched to vaping were twice as likely to die from lung cancer, compared with those who quit cold turkey.
Another study, this time from University College London and the University of Innsbruck in Austria, analyzed more than 3,500 oral swabs from smokers and e-cigarette users.
They found that epithelial cells (which normally line organs and are often where cancer begins) in the mouth showed substantial granular changes in smokers.
Similar changes were seen in the cells of e-cigarette users who had smoked fewer than 100 tobacco cigarettes in their lifetimes.
The patient underwent surgery to remove the mass, known as a resection. He then had to undergo three rounds of chemotherapy.
Synovial sarcoma is considered rare and accounts for about eight percent of tissue tumors, while it represents 15 to 20 percent of cases in adolescents and young adults.
For every million people, one to two are diagnosed with synovial sarcoma each year in the U.S.
Doctors said: “Due to its low frequency, diagnostic errors are common. Histologically, synovial sarcoma can present diverse growth patterns… which increases the challenge of diagnosis, especially in uncommon locations.”
The prognosis for this type of cancer is generally poor: an estimated 37 percent of patients survive after five years.
After three cycles of chemotherapy, an evaluation of the patient showed that the tumor had shrunk and the fluid around the lung had disappeared.
