Doctors find one-in-a-million cancer in 23-year-old after taking up common habit

A man in his 20s suffered a one-in-a-million cancer that may have been linked to his vaping habit.

The 23-year-old, from Indonesia, was found to have a tumor called synovial carcinoma which kills around 70 percent of its victims.

The tumor had developed in the tissue between his lungs, pushing his heart to the side and preventing it from pumping blood properly.

The patient was an e-cigarette user for about five years leading up to his health problems, which plagued him for three months before he was diagnosed. 

Vaping has been shown to potentially increase the risk of cancer, though the doctors cannot confirm if it was linked to the new patient’s tumor.

The young patient had been a regular user of e-cigarettes for about five years leading up to his diagnosis

The young man went to the hospital with shortness of breath for about two months, which worsened when he was lying down, and had chest pain and a cough for three months.

He also lost 11 pounds in that time. 

A physical exam showed 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 the upper right chest, and reduced breath sounds in the same area.

His doctors began a series of imaging tests, including X-rays and CT scans.

One scan showed a tumor on the right side of his chest near his lung. Another showed that the solid mass was compressing veins to the lung, the left side of the heart, a crucial artery going 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 cantaloupe, the doctors said.

His heart was also surrounded by fluid, and his lymph nodes were enlarged. The compression of various structures in the man’s chest reduced oxygen flow to the lungs, leading to breathing difficulties and impaired heart function.

Doctors said: ‘Synovial sarcoma macroscopically appears as a well-defined mass with variable size, ranging from 5 to 23 cm [about two to nine inches], with a soft to firm texture and invasion into surrounding tissues.

The mass pressed against his heart as well as other organs. It was about the length of a tablet and width of a small cantaloupe

‘Definitive diagnosis of synovial sarcoma can be challenging, even after tissue sampling. Immunohistochemistry can be helpful but insufficient as the tumor can histologically resemble other soft tissue tumors.’

Vaping has been tied to a higher risk of lung cancer. While it does not produce carcinogen-laced smoke in the same way that cigarettes do, the liquid in e-cigarettes contains thickeners and heavy metals that damage lung tissue. 

A study out of South Korea last year analyzed health data from 4.3million ex-smokers and found those who switched to vapes were twice as likely to die from lung cancer, compared to those who went cold turkey. 

Another study, this time from University College London and the University of Innsbruck, Austria, analyzed more than 3,500 cheek swabs of smokers and vape users. 

They found epithelial cells — which typically line organs and are often where cancer starts — in the mouth showed substantial granular changes in smokers.

Similar changes were observed in the cells of e-cigarette users who had smoked fewer than 100 tobacco cigarettes in their lives. 

The patient underwent surgery to remove the mass, known as a resection. He then had to go through three rounds of chemo.

Synovial sarcoma is considered rare and accounts for around eight percent of tissue tumors while accounting for 15 to 20 percent of the cases in adolescents and young adults.

For every one million people, one to two are diagnosed with synovial sarcoma per year in the US.

Doctors said: ‘Due to the infrequency, diagnostic errors are common. Histologically, synovial sarcoma can exhibit various growth patterns… adding to the diagnostic challenge, especially in uncommon locations.’

The prognosis of this type of cancer is generally poor, with an estimated 37 percent of patients surviving after five years.

After three cycles of chemo, an evaluation of the patient showed that the tumor had shrunk and the fluid around the lung had disappeared.