A 34-year-old man presented with two weeks of cough, unrelenting rib pain and shortness of breath. He has smoked three joints per day for seven years and also has a 12-pack year history of cigarette smoking.
His CT-chest revealed four distinct pathologies relating to his cannabis and cigarette smoke exposure: a) pneumothorax, b) emphysematous bulla, c) primary bronchogenic carcinoma and d) a rib metastasis.
The medicinal properties of cannabis are currently being re-evaluated and the clinical evidence is still evolving. However, cannabis smoking has been linked to an increased risk of lung cancer. One joint of cannabis has a similar toxic effect to one packet of cigarettes.1 Heavy cannabis smoking is also associated with lung bullae2 and an increased risk of pneumothoraces.3